Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0101249660 | VA |
NPI | 1275727059 |
---|---|
Provider Name | Ray Jay Espana Garcia |
First Address | Falls Church, VA 22042-1206 |
Second Address | Falls Church, VA 22042-1206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 09/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101249660 | LICENSE (01) | VA |