Provider Demographics
NPI:1932899283
Name:GARCIA, ANTONIO C
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:C
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 1:899 GRAY AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3635
Mailing Address - Country:US
Mailing Address - Phone:530-300-1000
Mailing Address - Fax:530-674-0545
Practice Address - Street 1:899 GRAY AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3635
Practice Address - Country:US
Practice Address - Phone:305-300-1000
Practice Address - Fax:530-674-0545
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90492225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist