Provider Demographics
NPI:1316176589
Name:GARCIA, JUAN CARLOS (BACHELOR'S OF SCIENC)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:CARLOS
Last Name:GARCIA
Suffix:
Gender:M
Credentials:BACHELOR'S OF SCIENC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 GRAND AVE # 106
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1765
Mailing Address - Country:US
Mailing Address - Phone:562-570-4337
Mailing Address - Fax:562-570-4033
Practice Address - Street 1:2525 GRAND AVE
Practice Address - Street 2:# 106
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1765
Practice Address - Country:US
Practice Address - Phone:562-570-4337
Practice Address - Fax:562-570-4033
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator