Provider Demographics
NPI:1215315353
Name:GARCIA, CHRISTIAN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERCADO ST STE 105
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7311
Mailing Address - Country:US
Mailing Address - Phone:970-382-8800
Mailing Address - Fax:970-382-0122
Practice Address - Street 1:1 MERCADO ST STE 105
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7311
Practice Address - Country:US
Practice Address - Phone:970-382-8800
Practice Address - Fax:970-382-0122
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58551207V00000X
CODR0067383207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0067383OtherCO MEDICAL LICENSE