Healthcare Provider Details

I. General information

NPI: 1609997618
Provider Name (Legal Business Name): ELBIN ALFREDO ORELLANA SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ELBIN ORELLANA M.D.

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 DEL REY BLVD
LAS CRUCES NM
88012
US

IV. Provider business mailing address

3751 DEL REY BLVD
LAS CRUCES NM
88012
US

V. Phone/Fax

Practice location:
  • Phone: 575-382-3500
  • Fax: 575-382-4900
Mailing address:
  • Phone: 575-382-3500
  • Fax: 575-382-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberMD2014-0115
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: