Provider Demographics
NPI:1386977296
Name:GARVIN GROUP
Entity type:Organization
Organization Name:GARVIN GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-258-7196
Mailing Address - Street 1:15455 RED HILL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7313
Mailing Address - Country:US
Mailing Address - Phone:714-258-7196
Mailing Address - Fax:714-258-7199
Practice Address - Street 1:15455 RED HILL AVE STE A
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7313
Practice Address - Country:US
Practice Address - Phone:714-258-7196
Practice Address - Fax:714-258-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center