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General NPI Number Information
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NPI Number | 1851401103
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Entity Type | Organization
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Legal Business Name | SANTA FE MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 2801 RODEO RD STE B-13
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City | SANTA FE
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State | NM
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Zip | 87507-6503
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Country | US
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Telephone | 505-474-0120
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Fax | 505-474-4693
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Provider Business Mailing Address
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Address Line | 7601 JEFFERSON BLVD NE STE 340
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4496
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Country | US
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Telephone | 505-338-3851
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Fax | 505-338-3859
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Authorized Official
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Title or Position | EXECUTIVE BILLING MG
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Name | CHRISTOPHER ELLIOT
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Credential |
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Telephone | 505-923-4634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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