Provider Demographics
NPI:1487877239
Name:GARCIA, EDWARD (AUD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-8258
Mailing Address - Country:US
Mailing Address - Phone:323-725-8135
Mailing Address - Fax:323-725-8138
Practice Address - Street 1:2455 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3040
Practice Address - Country:US
Practice Address - Phone:323-725-8135
Practice Address - Fax:323-725-8138
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1570231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AUD1570Medicare ID - Type Unspecified