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NPI Code Detail

MEDICARE: IRENE RODRIGUES GARCIA CCDC

MEDICARE: IRENE RODRIGUES GARCIA CCDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P123OTHERCAP123

General Provider Information

NPI Number : 1770767469
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE RODRIGUES GARCIA CCDC
Provider Business Mailing Address
First Line : 942 S ATLANTIC BLVD
Second Line : 1
City : LOS ANGELES
State : CA
Zip : 90022-4004
Country : US
Telephone Number : 323-263-9700
Fax Number : 323-263-8042
Provider Business Practice Location Address
First Line : 942 S ATLANTIC BLVD
Second Line : 1
City : LOS ANGELES
State : CA
Zip : 90022-4004
Country : US
Telephone Number : 323-263-9700
Fax Number : 323-263-8042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2007
Last Update Date : 12/18/2007

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Directions to “ IRENE RODRIGUES GARCIA CCDC” Practice Location

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