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General NPI Number Information
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NPI Number | 1730900812
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Entity Type | Individual
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Provider Name | DAVID SANABRIA CHW/R
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Gender | Male
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | PO BOX 3338
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City | TOHAJIILEE
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State | NM
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Zip | 87026-3338
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Country | US
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Telephone | 505-908-2307
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Fax |
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Provider Business Mailing Address
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Address Line | 3425 OASIS SPRINGS RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-2582
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Country | US
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Telephone | 505-659-3814
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | G-1618
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License Number State | NM
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