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NPI Code Detail

MEDICARE: RUBEN LEYVA

MEDICARE:   RUBEN  LEYVA
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1821399080
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBEN LEYVA
Provider Business Mailing Address
First Line : 1427 EL SEGUNDO AVE. N.E.
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87113
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1427 EL SEGUNDO AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87113-1087
Country : US
Telephone Number : 505-212-7350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2010
Last Update Date : 11/04/2010

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Directions to “ RUBEN LEYVA ” Practice Location

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