Basic Information
| Provider Information | |||||||||
| NPI: | 1235360355 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARZA | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | ISAAC | ||||||||
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| Credential: | LVN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 E BROADWAY APT 214 | ||||||||
| Address2: | |||||||||
| City: | SAN GABRIEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917766826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3236916590 | ||||||||
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| Practice Location | |||||||||
| Address1: | 66 HURLBUT ST | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911054025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264414221 | ||||||||
| FaxNumber: | 6264416479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 08/06/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN 199993 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.