MEDICARE: LUCIA CIES, M.D., P.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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1922208230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCIA CIES, M.D., P.C.

Provider Business Mailing Address
First Line	:	435 SAINT MICHAELS DR STE B201
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-7681
Country	:	US
Telephone Number	:	505-983-1213
Fax Number	:	505-983-9546

Provider Business Practice Location Address
First Line	:	435 SAINT MICHAELS DR STE B201
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-7681
Country	:	US
Telephone Number	:	505-983-1213
Fax Number	:	505-983-9546

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. NANCY GAGAN
Credential	:
Telephone Number	:	505-983-1213

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	07/24/2007

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