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NPI Code Detail

MEDICARE: DR. ERNESTO GARCIA D.D.S.

MEDICARE: DR. ERNESTO GARCIA D.D.S.
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
11223G0001XGeneral Practice Dentistry29279CA

General Provider Information

NPI Number : 1053560946
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERNESTO GARCIA D.D.S.
Provider Business Mailing Address
First Line : 4125 - 26TH STREET APT. #6
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94131-1929
Country : US
Telephone Number : 415-641-0917
Fax Number :
Provider Business Practice Location Address
First Line : 1701 NORTH EL DORADO STREET
Second Line :
City : STOCKTON
State : CA
Zip : 95204-5811
Country : US
Telephone Number : 209-462-2452
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2008
Last Update Date : 09/16/2008

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