Healthcare Provider Details

I. General information

NPI: 1285129395
Provider Name (Legal Business Name): TREI HOBBS DOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2018
Last Update Date: 04/30/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1642 SAINT MICHAELS DR
SANTA FE NM
87505-7712
US

IV. Provider business mailing address

626 GOMEZ RD
SANTA FE NM
87505-8819
US

V. Phone/Fax

Practice location:
  • Phone: 505-633-4192
  • Fax:
Mailing address:
  • Phone: 505-920-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1204
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: