Active NPI
Ivan Garcia
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1811481906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 27297
- Practice address
- 2051 Marengo St
Los Angeles, CA 90033-1352 - Phone
- (323) 409-1000
- NPI assigned
- Jun 21, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 27297 | CA | Primary |
Addresses
Primary practice location
2051 Marengo St
Los Angeles, CA 90033-1352
Mailing address
25383 Las Palomas Dr
Moreno Valley, CA 92557-7510
Other practice location 1
1350 Reche Canyon Rd
Colton, CA 92324-9528
Phone (909) 370-4411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27297 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529539200000",
"number": "1811481906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25383 LAS PALOMAS DR",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925577510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352",
"telephone_number": "323-409-1000"
}
],
"practiceLocations": [
{
"address_1": "1350 Reche Canyon Rd",
"address_purpose": "LOCATION",
"city": "Colton",
"state": "CA",
"postal_code": "923249528",
"country_code": "US",
"telephone_number": "909-370-4411",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARCIA",
"first_name": "IVAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-21",
"last_updated": "2018-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "27297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.