Provider Demographics
NPI:1447805148
Name:ENVERGA, JOHN VINCENT GARCIA (PA-C)
Entity type:Individual
Prefix:
First Name:JOHN VINCENT
Middle Name:GARCIA
Last Name:ENVERGA
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:17742 BEACH BLVD STE 345
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6872
Mailing Address - Country:US
Mailing Address - Phone:714-375-4224
Mailing Address - Fax:
Practice Address - Street 1:17742 BEACH BLVD STE 345
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6872
Practice Address - Country:US
Practice Address - Phone:714-375-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2024-01-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant