Individual provider Active NPI

Antonio M Garcia, MD

  • Pediatrics Physician
  • Pomona, CA
National Provider Identifier
1821177833
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A49168 Issued in CA
Practice address
586 E Mission Blvd
Pomona, CA 91766
Phone
(909) 622-6240
Fax
(909) 629-5736
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A49168 CA
Pediatrics Physician 208000000X A49168 CA Primary

Addresses

Primary practice location

586 E Mission Blvd
Pomona, CA 91766

Mailing address

586 E Mission Blvd
Pomona, CA 91766-1938
Phone (909) 622-6240

Other identifiers 1

IdentifierTypeStateIssuer
A49168MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611003265 CA Order and Referring Only - Family PracticePractitioner - Family Practice 5496076788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49168CAMDDentist
A49168CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Medical Clinic Inc Current Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1821177833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 E MISSION BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661938",
            "telephone_number": "909-622-6240",
            "fax_number": "909-629-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 E MISSION BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91766",
            "telephone_number": "909-622-6240",
            "fax_number": "909-629-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "ANTONIO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49168",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A49168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A49168",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.