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General NPI Number Information
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NPI Number | 1891984688
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Entity Type | Organization
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Legal Business Name | RICARDO ORTEGA MD, LLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5519 RABADI CASTLE AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-1412
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Country | US
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Telephone | 505-833-5091
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Fax | 505-352-6857
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Provider Business Mailing Address
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Address Line | 5519 RABADI CASTLE AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-1412
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Country | US
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Telephone | 505-833-5091
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Fax | 505-352-6857
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. RICARDO J ORTEGA
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Credential | MD
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Telephone | 505-833-5091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 81-280
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License Number State | NM
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