| Leo J Raschbaum Mdpc | |
|
5690 Santa Teresita Building A, Suite 4 Santa Teresa NM 88008 | |
| (505) 589-3022 | |
| (505) 589-3021 |
| Full Name | Leo J Raschbaum Mdpc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5690 Santa Teresita, Santa Teresa, New Mexico |
| Authorized Official Name and Position | Leopold Joseph Raschbaum (OWNER) |
| Authorized Official Contact | 5055893022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leo J Raschbaum Mdpc 1074 Country Club Rd Building A, Suite 4 Santa Teresa NM 88008-9757 Ph: (505) 589-3022 | Leo J Raschbaum Mdpc 5690 Santa Teresita Building A, Suite 4 Santa Teresa NM 88008 Ph: (505) 589-3022 |
| NPI Number | 1881792950 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 06/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881792950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 8588 (New Mexico) | Primary |
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