Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101257901 | VA |
Y | 111NI0900X | Internist | 0101257901 | VA |
N | 207R00000X | Internist | P0723 | TX |
N | 111NI0900X | Internist | P0723 | TX |
N | 207RA0401X | Internist - Addiction Medicine | 0101257901 | VA |
NPI | 1649596974 |
---|---|
Provider Name | Ivan F Garcia |
First Address | Falls Church, VA 22042-3300 |
Second Address | Falls Church, VA 22042-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 28/06/2021 |