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General NPI Number Information
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NPI Number | 1043759756
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Entity Type | Individual
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Provider Name | DIANA LYNN GABALDON PHARMD, PHC
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Gender | Female
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 201 CEDAR ST SE SUITE 4620
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4917
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Country | US
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Telephone | 505-563-1319
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Fax |
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Provider Business Mailing Address
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Address Line | 312 YUCCA DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87105-1935
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Country | US
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Telephone | 505-264-0168
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PC00000266
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License Number State | NM
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