Provider Demographics
NPI:1124310990
Name:GARCIA, LUIS
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1474
Mailing Address - Country:US
Mailing Address - Phone:717-845-8617
Mailing Address - Fax:717-854-0377
Practice Address - Street 1:116 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1474
Practice Address - Country:US
Practice Address - Phone:717-845-8617
Practice Address - Fax:717-854-0377
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD450780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine