Organization
ACACIA FAMILY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMANA REDDY M.D. (OWNER)
(931) 663-9500
Entity
Organization
Contact information
Practice address
8036 SAN MIGUEL CANYON RD, PRUNEDALE, CA 93907-1208
(831) 663-0123
(831) 663-9503
Mailing address
8020 SAN MIGUEL CANYON RD, PRUNEDALE, CA 93907-1208
(831) 663-9500
(831) 663-9503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0083011
—
CA
Enumeration date
05/22/2008
Last updated
05/22/2008
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