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NPI Code Detail

MEDICARE: CARLOS FERNANDO GARCIA D.D.S.

MEDICARE: CARLOS FERNANDO 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 Dentistry54413CA

General Provider Information

NPI Number : 1679796064
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS FERNANDO GARCIA D.D.S.
Provider Business Mailing Address
First Line : 362 3RD ST
Second Line : SUITE # 2
City : LAGUNA BEACH
State : CA
Zip : 92651-2307
Country : US
Telephone Number : 949-494-2111
Fax Number : 949-494-2125
Provider Business Practice Location Address
First Line : 362 3RD ST
Second Line : SUITE # 2
City : LAGUNA BEACH
State : CA
Zip : 92651-2307
Country : US
Telephone Number : 949-494-2111
Fax Number : 949-494-2125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 11/11/2014

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