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General NPI Number Information
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NPI Number | 1427292911
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Entity Type | Individual
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Provider Name | DIANE GARCIA PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 231 W VERNON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90037-2700
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Country | US
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Telephone | 323-231-8814
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Fax | 323-231-0134
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Provider Business Mailing Address
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Address Line | 407 N NORA AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-1517
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Country | US
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Telephone | 818-298-6539
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Fax | 323-231-0134
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19761
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License Number State | CA
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