Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD035947 | DC |
Y | 208600000X | Surgeon | MD035947 | DC |
N | 2086S0129X | Vascular Surgeon | D0064528 | MD |
NPI | 1124185681 |
---|---|
Provider Name | Jesse Patrick Garcia |
First Address | Alexandria, VA 22304-8705 |
Second Address | Washington, DC 20010-2927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 23/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057067200 | (05) | DC |
1140 VARNUM ST NE110 | NEW OFFICE LOCATION (01) | DC |
1609195585 | SOLE PROPRITOR METROPOLITAN VASCULAR ACCESS (01) | DC |
3634062 | MAIL HANDLERS COVENTRY HEALTH (01) | DC |
AS63 | CAREFIRST BCBS (01) | DC |
ENTITY 2 INDIVIDUAL | METROPOLITAN VASCULAR ACCESS (01) | DC |