Healthcare Provider Details

I. General information

NPI: 1275442238
Provider Name (Legal Business Name): UNIVERSITY OF NEW MEXICO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1727
US

IV. Provider business mailing address

1209 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1727
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4400
  • Fax: 505-925-7662
Mailing address:
  • Phone: 505-272-4400
  • Fax: 505-925-7662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARK TRUJILLO
Title or Position: MGR, PROVIDER REIMBURSEMENT
Credential:
Phone: 505-272-1287