| Acacia Family Practice Group Of Lake Havasu, Inc | |
|
1951 Mesquite Ave Ste H Lake Havasu City AZ 86403-5746 | |
| (928) 550-7036 | |
| Not Available |
| Full Name | Acacia Family Practice Group Of Lake Havasu, Inc |
|---|---|
| Speciality | General Practice |
| Location | 1951 Mesquite Ave Ste H, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Silvia Garcia (OWNER/CEO) |
| Authorized Official Contact | 9282464025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acacia Family Practice Group Of Lake Havasu, Inc 1951 Mesquite Ave Ste H Lake Havasu City AZ 86403-5746 Ph: (928) 550-7036 | Acacia Family Practice Group Of Lake Havasu, Inc 1951 Mesquite Ave Ste H Lake Havasu City AZ 86403-5746 Ph: (928) 550-7036 |
| NPI Number | 1295469641 |
|---|---|
| Provider Enumeration Date | 07/12/2022 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 2264818798 |
|---|---|
| Medicare Enrollment ID | O20221006000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295469641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Sherri S Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891714507 PECOS PAC ID: 9133268782 Enrollment ID: I20140520001997 |
| Provider Name | Dawn J Domenech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093171456 PECOS PAC ID: 2163728916 Enrollment ID: I20160304001221 |
| Provider Name | Kathy Karen Kladar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497197594 PECOS PAC ID: 3173749181 Enrollment ID: I20240112000695 |
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Frederic Luo, Md, Msee, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Mesquite Ave, Suite 102, Lake Havasu City, AZ 86403 Phone: 480-888-1900 Fax: 480-888-1934 | |
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