MEDICARE: ACACIA MOBILE CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1427906148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACACIA MOBILE CARE, INC

Provider Business Mailing Address
First Line	:	118 W STOCKER ST STE 3
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2509
Country	:	US
Telephone Number	:	747-977-0998
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 W STOCKER ST STE 3
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2509
Country	:	US
Telephone Number	:	747-977-0998
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN BURNS
Credential	:	MD
Telephone Number	:	747-977-0998

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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