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General NPI Number Information
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NPI Number | 1174729636
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Entity Type | Individual
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Provider Name | REBEKAH ANNE VALLEJOS MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 1501 SAN PEDRO DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5153
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Country | US
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Telephone | 505-265-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 438 LAS PAREDES
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City | CORRALES
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State | NM
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Zip | 87048-8021
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Country | US
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Telephone | 505-702-6480
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD2020-0222
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | D74691
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | MD2020-0222
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License Number State | NM
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