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Contact Information

SANTA ROSA MEDICAL CLINIC
533 LAKE DR
SANTA ROSA, NM88435
 Phone: 505-472-4311
 Fax: 505-472-4313
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SANTA ROSA MEDICAL CLINIC

NPI Number 1922039171
LBN Legal business name SANTA ROSA MEDICAL CLINIC
Authorized official SERGIO ABRIOLA - (MEDICAL DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/06/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
NM License # 20020002
NM Medicaid 78150728
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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