| Isleta Clinic | |
|
11000 Broadway Blvd Se Suite 1 Albuquerque NM 87105-7469 | |
| (505) 244-8116 | |
| Not Available |
| Full Name | Isleta Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 11000 Broadway Blvd Se, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jennifer L Sandoval (DIRECTOR OF CONTRACTING) |
| Authorized Official Contact | 5057270019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Isleta Clinic 11000 Broadway Blvd Se Suite 1 Albuquerque NM 87105-7469 Ph: (505) 244-8116 | Isleta Clinic 11000 Broadway Blvd Se Suite 1 Albuquerque NM 87105-7469 Ph: (505) 244-8116 |
| NPI Number | 1225357981 |
|---|---|
| Provider Enumeration Date | 05/20/2010 |
| Last Update Date | 05/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225357981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
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