Healthcare Provider Details

I. General information

NPI: 1548421571
Provider Name (Legal Business Name): RINA PATEL-TRUJILLO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 JEFFERSON ST NE
ALBUQUERQUE NM
87109-3437
US

IV. Provider business mailing address

5501 JEFFERSON ST NE
ALBUQUERQUE NM
87109-3437
US

V. Phone/Fax

Practice location:
  • Phone: 505-872-1002
  • Fax: 505-888-3708
Mailing address:
  • Phone: 505-872-1002
  • Fax: 505-888-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA-1744-13
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: