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SAN JUAN REGIONAL MEDICAL CENTER INC NPI 1093800534


NPI Information

NPI: 1093800534
Provider Name: SAN JUAN REGIONAL MEDICAL CENTER INC

Doing Business As: SAN JUAN PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
407 S SCHWARTZ AVE
SUITE 102
FARMINGTON, NM
ZIP 87401
Phone: (505) 609-6700
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SAN JUAN REGIONAL MEDICAL CENTER INC is a pediatrics in Farmington, NM. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SAN JUAN REGIONAL MEDICAL CENTER INC NPI is 1093800534. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As San Juan Pediatrics.

The provider's business location address is:

407 S SCHWARTZ AVE
SUITE 102
FARMINGTON, NM
ZIP 87401-925
Phone: (505) 609-6700
Fax: (505) 609-6701

The provider's authorized official is J. Michael Philips .
The authorized official title is Cso and has the following contact phone number (505) 324-6025.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 5/27/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000S8021MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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