| Evangelista Medical Group, Pc | |
|
2435 S Ave A Ste A Yuma AZ 85364-7176 | |
| (928) 726-6772 | |
| Not Available |
| Full Name | Evangelista Medical Group, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2435 S Ave A Ste A, Yuma, Arizona |
| Authorized Official Name and Position | Adelbert D Evangelista (PRESIDENT) |
| Authorized Official Contact | 9287828056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evangelista Medical Group, Pc 2435 S Ave A Yuma AZ 85364-7175 Ph: (928) 726-6772 | Evangelista Medical Group, Pc 2435 S Ave A Ste A Yuma AZ 85364-7176 Ph: (928) 726-6772 |
| NPI Number | 1295968584 |
|---|---|
| Provider Enumeration Date | 09/02/2009 |
| Last Update Date | 09/17/2009 |
| Medicare PECOS PAC ID | 5294873733 |
|---|---|
| Medicare Enrollment ID | O20091103000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295968584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 42221 (Arizona) | Primary |
| Provider Name | Adelbert Evangelista |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629018619 PECOS PAC ID: 8123031754 Enrollment ID: I20091103000654 |
| Provider Name | Jemylene Evangelista |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518142546 PECOS PAC ID: 2961540026 Enrollment ID: I20091110000331 |
| Provider Name | Sarah De Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427681162 PECOS PAC ID: 3779911938 Enrollment ID: I20200323000005 |
| Provider Name | Mary Jacqueline Ronsayro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053930081 PECOS PAC ID: 1658702956 Enrollment ID: I20200520000772 |
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