MEDICARE: LYNNE M.H GARCIA RD

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	133V00000X	Registered Dietitian	679322	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194839076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE M.H GARCIA RD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD
Second Line	:	SUITE 200
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5632
Country	:	US
Telephone Number	:	310-828-7172
Fax Number	:	310-394-7807

Provider Business Practice Location Address
First Line	:	1920 COLORADO AVE
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404
Country	:	US
Telephone Number	:	310-319-4700
Fax Number	:	310-394-7807

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	06/03/2014

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