Healthcare Provider Details

I. General information

NPI: 1962581686
Provider Name (Legal Business Name): JOSE ANTONIO GARCIA JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N K ST
TACOMA WA
98403-1623
US

IV. Provider business mailing address

223 N K ST
TACOMA WA
98403-1623
US

V. Phone/Fax

Practice location:
  • Phone: 253-572-4115
  • Fax: 253-572-7446
Mailing address:
  • Phone: 253-572-4115
  • Fax: 253-572-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00011694
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: