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General NPI Number Information
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NPI Number | 1326193624
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Entity Type | Individual
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Provider Name | VIRGINIA ELLEN GARRETT M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 3737 MCCRAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92506-2928
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Country | US
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Telephone | 951-823-0266
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Fax | 951-823-0266
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Provider Business Mailing Address
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Address Line | 3737 MCCRAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92506-2928
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Country | US
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Telephone | 951-823-0266
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Fax | 951-823-0266
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | G45812
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | G45812
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | G45812
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | G45812
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35-049101
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | 35-049101
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 35-049101
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | 35-049101
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 35-049101
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License Number State | OH
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