Individual
GENEVIEVE ISABEL GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1000
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA56142
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
STUDENT
STUDENT
—
Enumeration date
05/15/2018
Last updated
10/16/2018
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