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NPI Code Detail

MEDICARE: RUBEN GARCIA DE ALBA PA-C

MEDICARE: RUBEN GARCIA DE ALBA PA-C
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
1363A00000XPhysician AssistantPA-15262CA

General Provider Information

NPI Number : 1003965542
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBEN GARCIA DE ALBA PA-C
Provider Business Mailing Address
First Line : P.O. BOX 14545
Second Line : P.O. BOX 14545
City : TORRANCE
State : CA
Zip : 90501
Country : US
Telephone Number : 323-908-4200
Fax Number : 323-908-4262
Provider Business Practice Location Address
First Line : 4425 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-3629
Country : US
Telephone Number : 323-908-4200
Fax Number : 323-908-4262
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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