| JD Group | |
|
180 Dakota Ave Apt 57 Santa Cruz CA 95060-6615 | |
| (413) 330-1366 | |
| Not Available |
| Full Name | JD Group |
|---|---|
| Speciality | Family Medicine |
| Location | 180 Dakota Ave Apt 57, Santa Cruz, California |
| Authorized Official Name and Position | Jack Dunn (OWNER) |
| Authorized Official Contact | 4133301366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| JD Group 515 Granby Rd Chicopee MA 01013-3628 Ph: (413) 330-1366 | JD Group 180 Dakota Ave Apt 57 Santa Cruz CA 95060-6615 Ph: (413) 330-1366 |
| NPI Number | 1841917622 |
|---|---|
| Provider Enumeration Date | 10/24/2022 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 2062882889 |
|---|---|
| Medicare Enrollment ID | O20230111002693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841917622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207RI0200X | Internal Medicine - Infectious Disease | () | Secondary |
| Provider Name | Mayra Inez Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558978643 PECOS PAC ID: 9335507953 Enrollment ID: I20230614000788 |
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