Healthcare Provider Details

I. General information

NPI: 1013937408
Provider Name (Legal Business Name): SANTA FE IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 HOSPITAL DR
SANTA FE NM
87505-4754
US

IV. Provider business mailing address

1640 HOSPITAL DR
SANTA FE NM
87505-4754
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-9350
  • Fax: 505-955-8763
Mailing address:
  • Phone: 505-983-9350
  • Fax: 505-955-8763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN D LEHMAN
Title or Position: MANAGER
Credential: M.D.
Phone: 505-983-9350