Healthcare Provider Details

I. General information

NPI: 1164697868
Provider Name (Legal Business Name): OSUNA MEDICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 OSUNA RD NE
ALBUQUERQUE NM
87109-2527
US

IV. Provider business mailing address

5740 OSUNA RD NE
ALBUQUERQUE NM
87109-2527
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-9443
  • Fax: 505-881-4558
Mailing address:
  • Phone: 505-888-9443
  • Fax: 505-881-4558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number91-357
License Number StateNM

VIII. Authorized Official

Name: DR. ROBERT E ZUNIGA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 505-888-9443