Healthcare Provider Details
I. General information
NPI: 1497854921
Provider Name (Legal Business Name): CELIA VALDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/21/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 UNSER BLVD NW
ALBUQUERQUE NM
87121-1927
US
IV. Provider business mailing address
800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US
V. Phone/Fax
- Phone: 505-925-4126
- Fax: 505-272-6308
- Phone: 505-272-1476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 87-341 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: