| Acacia Family Practice Group Inc | |
|
888 W 16th St Yuma AZ 85364-4542 | |
| (928) 550-7000 | |
| Not Available |
| Full Name | Acacia Family Practice Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 888 W 16th St, Yuma, Arizona |
| Authorized Official Name and Position | Jesus Garcia (CEO) |
| Authorized Official Contact | 9287269163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acacia Family Practice Group Inc 888 W 16th St Yuma AZ 85364-4542 Ph: (928) 550-7000 | Acacia Family Practice Group Inc 888 W 16th St Yuma AZ 85364-4542 Ph: (928) 550-7000 |
| NPI Number | 1316508211 |
|---|---|
| Provider Enumeration Date | 06/22/2019 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 6507192143 |
|---|---|
| Medicare Enrollment ID | O20190719001980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316508211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John N Gietzen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538178025 PECOS PAC ID: 0446154397 Enrollment ID: I20050127000330 |
| Provider Name | Dawn J Domenech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093171456 PECOS PAC ID: 2163728916 Enrollment ID: I20160304001221 |
| Provider Name | Rebecca Ann Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871732370 PECOS PAC ID: 3274848593 Enrollment ID: I20180213001536 |
| Provider Name | Laura C Spindola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629536859 PECOS PAC ID: 5294069548 Enrollment ID: I20190620002243 |
| Provider Name | Melissa Marie Hare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528727468 PECOS PAC ID: 6901293257 Enrollment ID: I20220505000323 |
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