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General NPI Number Information
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NPI Number | 1922190040
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Entity Type | Individual
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Provider Name | CHARLES F PACE MD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 4824 MCMAHON BLVD NW SUITE 119
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5412
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Country | US
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Telephone | 505-898-1595
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Fax | 505-898-0846
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Provider Business Mailing Address
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Address Line | 4824 MCMAHON BLVD NW SUITE 119
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5412
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Country | US
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Telephone | 505-898-1595
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Fax | 505-898-0846
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2000-259
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License Number State | NM
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