Healthcare Provider Details

I. General information

NPI: 1629865084
Provider Name (Legal Business Name): CHRISTOPHER JOSEPH LOVATO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3736 EUBANK BLVD NE STE B1
ALBUQUERQUE NM
87111-3583
US

IV. Provider business mailing address

54 ANASAZI TRAILS LOOP
PLACITAS NM
87043-8760
US

V. Phone/Fax

Practice location:
  • Phone: 505-293-2881
  • Fax:
Mailing address:
  • Phone: 505-331-4668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: