Los Alamos Pediatric Clinic

NPI 1245248830 - Pediatrics - 208000000X

NPI Details
NPI 1245248830
Enumeration Date 08/03/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JACQUELINE ANNE JACQUELINE
Position PRESIDENT
Phone (505) 662-9620
Fax (505) 662-0024
Practice Location
3917 WEST ROAD
SUITE 136
LOS ALAMOS NM, 87544, US
Phone (505) 662-9620
Fax (505) 662-0024
Business Location
3917 WEST ROAD
SUITE 136
LOS ALAMOS NM, 87544, US
Phone (505) 662-9620
Fax (505) 662-0024
Toxanomy
Taxonomy Code 208000000X
License State New Mexico
License Number 79195
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According to our database, Los Alamos Pediatric Clinic NPI is 1245248830, taxonomy code is 208000000X and license number is 79195, license state is located at New Mexico. Los Alamos Pediatric Clinic physically located at 3917 West Road, Los Alamos NM, 87544. NPI Number 1033115704 has the healthcare provider type.

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1245248830 NPI number is provided on an as is basis without warranty of any kind. 1245248830 is maintained by the National Plan & Provider Enumeration System. The contents of Los Alamos Pediatric Clinic are for informational purposes only.