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NPI Code Detail

MEDICARE: DR. DOMINIC POMO DNAP, CRNA

MEDICARE: DR. DOMINIC POMO DNAP, CRNA
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
1367500000XCertified Registered Nurse Anesthetist156777IN

General Provider Information

NPI Number : 1073483624
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOMINIC POMO DNAP, CRNA
Provider Business Mailing Address
First Line : 5992 CORRALES RD
Second Line :
City : CORRALES
State : NM
Zip : 87048-8774
Country : US
Telephone Number : 575-312-4712
Fax Number :
Provider Business Practice Location Address
First Line : 2400 UNSER BLVD SE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-3392
Country : US
Telephone Number : 505-253-7878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2025
Last Update Date : 12/18/2025

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