Individual
RICARDO MARAVILLA-GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2215 BLUE GUM AVE, MODESTO, CA 95358-1052
(209) 525-5401
Mailing address
522 E GRANGER AVE, MODESTO, CA 95350-4545
(209) 558-4610
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/19/2019
Last updated
08/23/2023
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