Healthcare Provider Details

I. General information

NPI: 1871500819
Provider Name (Legal Business Name): JOSEPH AGUIRRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 04/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 LOMAS NE
ALBUQUERQUE NM
87106-2745
US

IV. Provider business mailing address

933 BRADBURY SE SUITE 2222
ALBUQUERQUE NM
87106-4301
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2345
  • Fax:
Mailing address:
  • Phone: 505-272-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number83-148
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: