Provider Demographics
NPI:1699771204
Name:GARCIA, ELENA B (MD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:B
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10120 W FLAMINGO RD STE 4-142
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8392
Mailing Address - Country:US
Mailing Address - Phone:702-739-9555
Mailing Address - Fax:702-739-9060
Practice Address - Street 1:366 W LAKE MEAD PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7287
Practice Address - Country:US
Practice Address - Phone:702-359-5210
Practice Address - Fax:702-997-0475
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2021-02-17
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Provider Licenses
StateLicense IDTaxonomies
NV11464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV105854Medicare PIN