Healthcare Provider Details

I. General information

NPI: 1679216030
Provider Name (Legal Business Name): MARIA ISABEL DIAZMORFIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 LAS LOMAS RD NE # NA
ALBUQUERQUE NM
87102-2633
US

IV. Provider business mailing address

904 LAS LOMAS RD NE # NA
ALBUQUERQUE NM
87102-2633
US

V. Phone/Fax

Practice location:
  • Phone: 505-916-1932
  • Fax:
Mailing address:
  • Phone: 505-916-1932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMD2025-0772
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: