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General NPI Number Information
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NPI Number | 1851885628
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Entity Type | Individual
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Provider Name | BAGAMBHRINI GERACE THOMPKINS MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 4801 BECKNER RD STE 1600 FAMILY MEDICINE - SANTA FE
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City | SANTA FE
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State | NM
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Zip | 87507-3641
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Country | US
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Telephone | 505-772-2000
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Fax | 505-772-6284
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 505-772-2000
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Fax | 505-772-6284
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 61796
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2024-0131
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License Number State | NM
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