Active NPI
Miguel Garcia, PA-C
- Physician Assistant
- Fontana, CA
National Provider Identifier
1568656262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18265
- Practice address
- 16980 Foothill Blvd
Fontana, CA 92335-3569 - Phone
- (909) 434-0808
- Fax
- (909) 434-0616
- NPI assigned
- Sep 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18265 | CA | Primary |
Addresses
Primary practice location
16980 Foothill Blvd
Fontana, CA 92335-3569
Mailing address
16980 Foothill Blvd
Fontana, CA 92335-3569
Phone (909) 434-0808
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071215000166 | CA | Practitioner - Physician Assistant | 2769572676 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18265 | CA | MD | Professional Counselor |
| PA18265 | CA | MD | Physician Assistant |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1568656262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16980 FOOTHILL BLVD",
"city": "FONTANA",
"state": "CA",
"postal_code": "923353569",
"telephone_number": "909-434-0808",
"fax_number": "909-434-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16980 FOOTHILL BLVD",
"city": "FONTANA",
"state": "CA",
"postal_code": "923353569",
"telephone_number": "909-434-0808",
"fax_number": "909-434-0616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "MIGUEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-05",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.