Provider Demographics
NPI:1154558450
Name:YUMA PHYSICIANS MEDICAL CLINIC, P.C.
Entity type:Organization
Organization Name:YUMA PHYSICIANS MEDICAL CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-782-0218
Mailing Address - Street 1:1079 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8347
Mailing Address - Country:US
Mailing Address - Phone:928-782-0218
Mailing Address - Fax:928-782-1556
Practice Address - Street 1:1079 W 23RD ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8347
Practice Address - Country:US
Practice Address - Phone:928-782-0218
Practice Address - Fax:928-782-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty