# IVAN GARCIA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1164109112
- **Gender:** Man
- **Credential:** PHYSICIAN ASSISTANT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 001423 | PR | Yes |
| 363A00000X | Physician Assistant | 001423-PA | PR | — |
| 363AM0700X | Medical Physician Assistant | 001423-PA | — | — |

## Other

- **Enumeration date:** 06/30/2023
- **Last updated:** 06/30/2023