National Provider Identifier Database

NM OPTIMUM MEDICAL GROUP LLC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

NM OPTIMUM MEDICAL GROUP, LLC
425 S TELSHOR BLVD # C201B
LAS CRUCES, NM88011-8235
Phone: 575-522-1200
Fax: 575-288-2063
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for NM OPTIMUM MEDICAL GROUP, LLC

NPI Number 1184005860
Legal business name
LBN
NM OPTIMUM MEDICAL GROUP, LLC
Authorized official MARCOS ESTRADA - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 06/17/2015
Last updated 02/15/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: MD2012-0160

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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