Individual provider Active NPI

Heidi Rae Garcia, PAC

  • Physician Assistant
  • Gardena, CA
National Provider Identifier
1508853136
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13904 Issued in CA
Practice address
1141 W Redondo Beach Blvd
Suite 104
Gardena, CA 90247-3586
Phone
(310) 538-9400
Fax
(310) 538-0101
NPI assigned
Sep 29, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13904 CA Primary

Addresses

Primary practice location

1141 W Redondo Beach Blvd
Suite 104
Gardena, CA 90247-3586

Mailing address

3228 W 154TH St
Gardena, CA 90249-4016
Phone (310) 715-2185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814003597 CA Order and Referring Only - Physician Assistant 6204335508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Family Medical Group Inc Past Accepting new patients
Narbonne Multispecialty Medical Group, Inc Past Accepting new patients
Healthcare Partners Affiliates Medical Group Past Accepting new patients
Ramos Medical Associates Inc PastSince May 10, 1999 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508853136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3228 W 154TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494016",
            "telephone_number": "310-715-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "SUITE 104",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473586",
            "telephone_number": "310-538-9400",
            "fax_number": "310-538-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "HEIDI",
        "middle_name": "RAE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "13904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.