Los Alamos Family Practice P A | |
3917 West Rd Suite 130 Los Alamos NM 87544-2275 | |
(505) 662-2900 | |
Not Available |
Full Name | Los Alamos Family Practice P A |
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Speciality | Family Medicine |
Location | 3917 West Rd, Los Alamos, New Mexico |
Authorized Official Name and Position | Phillip Alan Hertzman (PRESIDENT) |
Authorized Official Contact | 5056622900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Los Alamos Family Practice P A 3917 West Rd Suite 130 Los Alamos NM 87544-2275 Ph: () - | Los Alamos Family Practice P A 3917 West Rd Suite 130 Los Alamos NM 87544-2275 Ph: (505) 662-2900 |
NPI Number | 1285857664 |
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Provider Enumeration Date | 04/11/2007 |
Last Update Date | 11/01/2007 |
Medicare PECOS PAC ID | 3779674189 |
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Medicare Enrollment ID | O20070814000222 |
Identifier | Type | State | Issuer |
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1285857664 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
Provider Name | Phillip A Hertzman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659463784 PECOS PAC ID: 4082705496 Enrollment ID: I20070814000184 |
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