Basic Information
| Provider Information | |||||||||
| NPI: | 1679791578 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | GARZA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 504 PLAZA DR | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934546917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057393890 | ||||||||
| FaxNumber: | 8053477697 | ||||||||
| Practice Location | |||||||||
| Address1: | 117 WEST BUNNY AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934582805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057393890 | ||||||||
| FaxNumber: | 8053477697 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 02/24/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A88128 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | FHC70593F | 05 | CA | MEDICAID | CB241378 | 01 | CA | MEDICARE ID | OTHER | BCP70477F | 01 | CA | BCP | OTHER | FHC70477F | 05 | CA | MEDICAID | HAP70477F | 01 | CA | FAMILY PACT | OTHER |