Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | D.C.20191 | CA |
NPI | 1316069230 |
---|---|
Provider Name | Hector Eugenio Garcia |
First Address | San Diego, CA 92117-6673 |
Second Address | San Diego, CA 92117-6673 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |