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General NPI Number Information
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NPI Number | 1295350437
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Entity Type | Organization
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Legal Business Name | CLINICA PARA TODOS
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Dates
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Enumeration Date | 06/13/2020
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Last Update Date | 06/13/2020
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Provider Practice Location Address
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Address Line | 7345 YORKTOWN AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5070
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Country | US
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Telephone | 505-681-8295
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Fax |
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Provider Business Mailing Address
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Address Line | 7345 YORKTOWN AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5070
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Country | US
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Telephone | 505-681-8295
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Fax |
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Authorized Official
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Title or Position | CFNP
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Name | DOLORES J CORDOVA
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Credential | CFNP
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Telephone | 575-644-0480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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