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General NPI Number Information
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NPI Number | 1073619805
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Entity Type | Individual
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Provider Name | RODOLFO M GARCIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 808 IOWA AVE
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City | LOS BANOS
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State | CA
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Zip | 93635
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Country | US
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Telephone | 209-710-4124
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Fax | 209-710-4131
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Provider Business Mailing Address
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Address Line | 808 IOWA AVE
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City | LOS BANOS
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State | CA
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Zip | 93635-3450
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Country | US
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Telephone | 209-710-4124
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Fax | 209-710-4131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A39112
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License Number State | CA
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