Provider Demographics
NPI:1588422513
Name:GARCIA, ANTHONY CRISTOS
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:CRISTOS
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4687 S LEWISTON WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1607
Mailing Address - Country:US
Mailing Address - Phone:720-375-1584
Mailing Address - Fax:
Practice Address - Street 1:4687 S LEWISTON WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1607
Practice Address - Country:US
Practice Address - Phone:720-213-8292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO95-241-0346172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver