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Organization
MAMDANI GARCIA MD INC
Active
Organization
MAMDANI GARCIA MD INC
Active
Other names
Walk-in Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE KRISTINE GARCIA (OFFICE ADMINISTRATOR)
(209) 826-5913
Entity
Organization
Contact information
Practice address
808 IOWA AVE, LOS BANOS, CA 93635-3450
(209) 826-5913
(209) 826-2652
Mailing address
808 IOWA AVE, LOS BANOS, CA 93635-3450
(209) 826-5913
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A14153
CA LICENSE
CA
01
—
272621
LICENSE
NY
Enumeration date
03/07/2019
Last updated
07/27/2020
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