| Doctor Name: | SERGIO I MACIAS |
| NPI Number: | 1578570081 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | C001071 |
| Business Practice Address: | 1233 N Main Street Suite 10, 11 & 12 San Luis, AZ - 853499999 |
| Business Phone Number: | 9287226050 |
| Business Fax Number: | 9287226094 |
| Mailing Address: | Po Box 5841, YUMA |
| State: | AZ |
| Postal Code: | 853662490 |
| Phone Number: | 9283437911 |
| Fax Number: | 9283439528 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | C001071 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |