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Individual

SAMANTHA GARCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
124 GLENDALE AV, OXNARD, CA 93035
(626) 975-4745
Mailing address
124 GLENDALE AVE, OXNARD, CA 93035-4511
(626) 975-4745

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
6596
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6596
IDC
CA
Enumeration date
03/04/2011
Last updated
09/22/2011
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