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General NPI Number Information
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NPI Number | 1235360355
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Entity Type | Individual
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Provider Name | JOSE ISAAC GARZA LVN
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 66 HURLBUT ST
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City | PASADENA
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State | CA
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Zip | 91105-4025
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Country | US
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Telephone | 626-441-4221
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Fax | 626-441-6479
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Provider Business Mailing Address
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Address Line | 315 E BROADWAY APT 214
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City | SAN GABRIEL
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State | CA
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Zip | 91776-6826
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Country | US
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Telephone | 323-691-6590
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Fax |
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN 199993
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License Number State | CA
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