Provider Demographics
NPI:1124127659
Name:GARCIA-HERRERA, RONALD PAUL (PA-C)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:PAUL
Last Name:GARCIA-HERRERA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:RONALD
Other - Middle Name:PAUL
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:4 ROSSI CIR
Mailing Address - Street 2:SUITE 141
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2362
Mailing Address - Country:US
Mailing Address - Phone:831-757-4444
Mailing Address - Fax:831-757-4419
Practice Address - Street 1:285 MERCEY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-3878
Practice Address - Country:US
Practice Address - Phone:209-829-0444
Practice Address - Fax:209-829-0445
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACF993ZMedicare PIN