MEDICARE: AUGUST VOJDANI PA-C

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
1	363A00000X	Physician Assistant	PA2022-0090	NM

General Provider Information

NPI Number	:	1215525902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUGUST VOJDANI PA-C

Provider Business Mailing Address
First Line	:	PO BOX 26666
Second Line	:	PHS PROVIDER ENROLLMENT
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-6666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4588 PARADISE BLVD NW
Second Line	:	MEDICARE ADVANTAGE CLINIC
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-4105
Country	:	US
Telephone Number	:	505-998-1840
Fax Number	:	505-998-1841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2021
Last Update Date	:	04/05/2025

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Directions to “ AUGUST VOJDANI PA-C” Practice Location

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