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NPI Code Detail

MEDICARE: DR. CORAZON GARCIA ANTONIO M.D.

MEDICARE: DR. CORAZON GARCIA ANTONIO M.D.
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
12084P0800XPsychiatry PhysicianA37362CA
22084P0800XPsychiatry Physician01029237AIN

Other Identifiers

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

General Provider Information

NPI Number : 1689607582
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORAZON GARCIA ANTONIO M.D.
Provider Business Mailing Address
First Line : PO BOX 809
Second Line :
City : GOSHEN
State : IN
Zip : 46527-0809
Country : US
Telephone Number : 574-533-1234
Fax Number : 574-537-2652
Provider Business Practice Location Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number : 248-475-2168
Fax Number : 248-475-6403
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 03/26/2018

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