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NPI Code Detail

MEDICARE: JUAN SEBASTIAN SOCHE

MEDICARE: JUAN SEBASTIAN SOCHE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD2022-1477NM
2390200000XStudent in an Organized Health Care Education/Training ProgramNM

General Provider Information

NPI Number : 1023672565
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN SEBASTIAN SOCHE
Provider Business Mailing Address
First Line : 1625 RIO BRAVO BLVD SW STE 36
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87105-6060
Country : US
Telephone Number : 505-226-0153
Fax Number : 505-808-4990
Provider Business Practice Location Address
First Line : 1625 RIO BRAVO BLVD SW STE 36
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87105-6060
Country : US
Telephone Number : 505-777-3004
Fax Number : 505-808-4990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2019
Last Update Date : 03/25/2026

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Directions to “ JUAN SEBASTIAN SOCHE ” Practice Location

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