Basic Information
| Provider Information | |||||||||
| NPI: | 1437273687 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | LEANDRO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 WEST BUNNY AVENUE | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934582805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057393968 | ||||||||
| FaxNumber: | 8059226101 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 SOUTH PALISADE DRIVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SANTA MARIA, | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934548905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057393968 | ||||||||
| FaxNumber: | 8059226101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 12/31/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 112173 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | CB244946 | 01 | CA | MEDICARE ID | OTHER |