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NPI Code Detail

MEDICARE: DR. PATRICIA MAGDALENA ROCHA M.D.

MEDICARE:  DR. PATRICIA MAGDALENA ROCHA  M.D.
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 PhysicianA92197CA
2207Q00000XFamily Medicine PhysicianMD2004-0636NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548260052
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA MAGDALENA ROCHA M.D.
Provider Business Mailing Address
First Line : 1423 E ROOSEVELT AVE
Second Line :
City : GRANTS
State : NM
Zip : 87020-2245
Country : US
Telephone Number : 505-287-6500
Fax Number : 505-287-9053
Provider Business Practice Location Address
First Line : 1423 E ROOSEVELT AVENUE
Second Line :
City : GRANTS
State : NM
Zip : 87020-2118
Country : US
Telephone Number : 505-287-6500
Fax Number : 505-287-9053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 11/13/2014

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