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Contact Information

GRAY PEARLS LLC
2506 TRAMWAY TERRACE CT NE
ALBUQUERQUE, NM87122-2317
 Phone: 505-506-1984
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GRAY PEARLS LLC

NPI Number 1932562360
LBN Legal business name GRAY PEARLS LLC
Authorized official ELLEN KIM - (SOLE MEMBER/PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 04/02/2016
Last updated 04/02/2016 - About 10 years ago
Identifiers
NM License # 97-289
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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