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NPI Code Detail

MEDICARE: SOUTHWEST EMERGENCY MEDICAL ASSOCIATES OF NM PC

MEDICARE: SOUTHWEST EMERGENCY MEDICAL ASSOCIATES OF NM PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363L00000XNurse Practitioner
3207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1720505571
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST EMERGENCY MEDICAL ASSOCIATES OF NM PC
Provider Business Mailing Address
First Line : 5000 HOPYARD RD STE 100
Second Line :
City : PLEASANTON
State : CA
Zip : 94588-3146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 S. TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5076
Country : US
Telephone Number : 954-924-1600
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOSE CRESPO
Credential : MD
Telephone Number : 865-693-1000
Provider Enumeration Date : 08/23/2017
Last Update Date : 08/23/2017

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Directions to “SOUTHWEST EMERGENCY MEDICAL ASSOCIATES OF NM PC ” Practice Location

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