Healthcare Provider Details

I. General information

NPI: 1891866331
Provider Name (Legal Business Name): VICTORIA GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CEDAR ST SE STE 304
ALBUQUERQUE NM
87106-4932
US

IV. Provider business mailing address

201 CEDAR ST SE STE 304
ALBUQUERQUE NM
87106-4932
US

V. Phone/Fax

Practice location:
  • Phone: 505-843-7813
  • Fax: 505-843-6947
Mailing address:
  • Phone: 505-843-7813
  • Fax: 505-843-6947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD2004-0567
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: