MEDICARE: CHRISTOPHER MICHAEL GARCIA

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	171M00000X	Case Manager/Care Coordinator	SUPERVISED	AZ
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	SUPERVISED	AZ

General Provider Information

NPI Number	:	1912692310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MICHAEL GARCIA

Provider Business Mailing Address
First Line	:	8518 E INDIGO ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85207-3185
Country	:	US
Telephone Number	:	480-637-8201
Fax Number	:

Provider Business Practice Location Address
First Line	:	8518 E INDIGO ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85207-3185
Country	:	US
Telephone Number	:	480-637-8201
Fax Number	:

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

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	04/10/2023

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