Healthcare Provider Details

I. General information

NPI: 1679739684
Provider Name (Legal Business Name): NAVNEET KAINTH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAVNEET M. MANGAT M.D.

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 04/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S SCHWARTZ AVE SUITE 201
FARMINGTON NM
87401-5925
US

IV. Provider business mailing address

PO BOX 6210
FARMINGTON NM
87499-6210
US

V. Phone/Fax

Practice location:
  • Phone: 505-609-6730
  • Fax: 505-609-6749
Mailing address:
  • Phone: 505-609-2258
  • Fax: 505-609-2259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD2014-0685
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: