MEDICARE: SCI NEW MEXICO PC SKIN AND CANCER INSTITUTE - LAS CRU

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207ZD0900X	Dermatopathology (Pathology) Physician
2	2085R0001X	Radiation Oncology Physician
3	207ND0101X	MOHS-Micrographic Surgery Physician
4	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1932910866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCI NEW MEXICO PC SKIN AND CANCER INSTITUTE - LAS CRU

Provider Business Mailing Address
First Line	:	PO BOX 16297
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90209-2297
Country	:	US
Telephone Number	:	661-388-5240
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 E LOHMAN AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-3667
Country	:	US
Telephone Number	:	888-993-3761
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR CREDENTIALING
Name	:	SHERI ALLEY
Credential	:
Telephone Number	:	661-388-5240

Provider Enumeration Date	:	01/20/2025
Last Update Date	:	02/03/2026

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