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General NPI Number Information
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NPI Number | 1821343286
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Entity Type | Organization
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Legal Business Name | HEIGHTS MEDICAL CONSULTANTS PA
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 07/20/2012
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Provider Practice Location Address
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Address Line | 4300 SAN MATEO BLVD NE SUITE B270
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1229
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Country | US
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Telephone | 505-883-7525
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Fax | 505-883-7535
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Provider Business Mailing Address
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Address Line | 4300 SAN MATEO BLVD NE SUITE B270
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1229
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Country | US
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Telephone | 505-883-7525
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Fax | 505-883-7535
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH RUBEN PEREA
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Credential | M.D.
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Telephone | 505-883-7525
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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 | NM8079
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License Number State | NM
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