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General NPI Number Information
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NPI Number | 1124474606
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Entity Type | Organization
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Legal Business Name | RAYMUNDO M GARCIA LORA M.D., INC
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 1920 E KATELLA AVE STE P
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City | ORANGE
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State | CA
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Zip | 92867-5150
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Country | US
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Telephone | 714-639-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 E KATELLA AVE STE P
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City | ORANGE
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State | CA
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Zip | 92867-5150
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Country | US
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Telephone | 714-639-3060
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAYMUNDO M GARCIA
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Credential | M.D
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Telephone | 714-639-3960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A137841
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License Number State | CA
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