=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174612535
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAMIRO GARCIA MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11420 E 37TH PL
-----------------------------------------------------
City | YUMA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85367-5671
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-482-7371
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 649 E NAPLES ST
-----------------------------------------------------
City | CHULA VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91911-6837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-313-1540
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RAMIRO R GARCIA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 619-313-1540
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 11867
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------