Provider Demographics
NPI:1871162511
Name:ARANA GARCIA, MARVIN ANTONIO
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:ANTONIO
Last Name:ARANA GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MARVIN
Other - Middle Name:ANTONIO
Other - Last Name:ARANA GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7181 MAGNOLIA PL
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5715
Mailing Address - Country:US
Mailing Address - Phone:626-488-7129
Mailing Address - Fax:
Practice Address - Street 1:7181 MAGNOLIA PL
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-5715
Practice Address - Country:US
Practice Address - Phone:626-488-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF7462476172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver