Healthcare Provider Details

I. General information

NPI: 1760632061
Provider Name (Legal Business Name): MICHAEL H TRUJILLO M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 GIBSON BLVD., SE ABQ HEALTH PARTNERS
ALBUQUERQUE NM
87108
US

IV. Provider business mailing address

5400 GIBSON BLVD, SE ABQ HEALTH PARTNERS
ALBUQUERQUE NM
87108
US

V. Phone/Fax

Practice location:
  • Phone: 505-262-3247
  • Fax: 505-232-1386
Mailing address:
  • Phone: 505-232-3247
  • Fax: 505-232-1386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number78-276
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: