MEDICARE: MRS. LAREINA GARZA CPM, LM

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	176B00000X	Midwife	507	CA
2	374J00000X	Doula		CA

General Provider Information

NPI Number	:	1639519622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAREINA GARZA CPM, LM

Provider Business Mailing Address
First Line	:	PO BOX 2215
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-0042
Country	:	US
Telephone Number	:	760-963-9762
Fax Number	:	888-515-8123

Provider Business Practice Location Address
First Line	:	20807 US HIGHWAY 18
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-3549
Country	:	US
Telephone Number	:	760-963-3762
Fax Number	:	888-515-8123

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

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	03/17/2018

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