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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

NPI Number 1245248830
LBN Legal business name LOS ALAMOS PEDIATRIC CLINIC
Authorized official JACQUELINE KROHN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/03/2006
Last updated 08/22/2020 - About 6 years ago
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
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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