MEDICARE: DR. ALFRED SALOMON GARCIA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	32184	CA

General Provider Information

NPI Number	:	1003186792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFRED SALOMON GARCIA DC

Provider Business Mailing Address
First Line	:	1125 EAST 16TH STREET UNIT 4.
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91784
Country	:	US
Telephone Number	:	562-746-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 E 16TH ST
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91784-9179
Country	:	US
Telephone Number	:	562-746-7077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2012
Last Update Date	:	01/11/2012

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