Healthcare Provider Details

I. General information

NPI: 1306370358
Provider Name (Legal Business Name): DESERT SUN ACUPUNCTURE AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 HOMESTEAD RD NE STE 202A
ALBUQUERQUE NM
87110-1524
US

IV. Provider business mailing address

PO BOX 94508
ALBUQUERQUE NM
87199-4508
US

V. Phone/Fax

Practice location:
  • Phone: 505-304-7228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1123
License Number StateNM

VIII. Authorized Official

Name: MAGDELENA SANCHEZ
Title or Position: DOM
Credential:
Phone: 550-220-0468