Physician Compare National (NPI:1336224393)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1336224393
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820018146
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051201000664
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GARCIA
	Individual professional last name
Provider First Name	ROBERTO
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF UTAH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2140 W 24TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	YUMA
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	853648877
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9287824791
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030013
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	YUMA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y