Provider Demographics
NPI:1871764407
Name:GARCIA-MACIAS, ROMEO (LAC)
Entity type:Individual
Prefix:MR
First Name:ROMEO
Middle Name:
Last Name:GARCIA-MACIAS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5503
Mailing Address - Country:US
Mailing Address - Phone:323-851-7161
Mailing Address - Fax:
Practice Address - Street 1:7500 HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5503
Practice Address - Country:US
Practice Address - Phone:323-851-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12256171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist