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Contact Information

LOS ALAMOS PEDIATRIC CLINIC
3917 WEST ROAD
SUITE 136
LOS ALAMOS, NM87544
 Phone: 505-662-9620
 Fax: 505-662-0024
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for LOS ALAMOS PEDIATRIC CLINIC · (Female)

NPI Number 1245248830
Status Active
Credentials
Entity Individual
Enumeration date 08/03/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • NM License # 79195
  • NM Medicaid 11783
  • NM Other NM011552 BCBS
  • NM Other 6693 HMA NAVAJO NATION
  • NM Other 10003513 LOVELACE HEALTH
  • NM Other PROVP13573 MOLINA HEALTHCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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