Optimum Medical Care | |
2404 S. Locust Suite #2 Las Cruces NM 88001-8627 | |
(575) 521-1919 | |
Not Available |
Full Name | Optimum Medical Care |
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Speciality | Clinic/Center |
Location | 2404 S. Locust, Las Cruces, New Mexico |
Authorized Official Name and Position | Benito Gallardo (MEDICAL DIRECTOR) |
Authorized Official Contact | 5755211919 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Optimum Medical Care Po Box 2278 Las Cruces NM 88004-2278 Ph: (575) 521-1919 | Optimum Medical Care 2404 S. Locust Suite #2 Las Cruces NM 88001-8627 Ph: (575) 521-1919 |
NPI Number | 1639349426 |
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Provider Enumeration Date | 03/07/2008 |
Last Update Date | 03/11/2011 |
Medicare PECOS PAC ID | 8729260500 |
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Medicare Enrollment ID | O20110316000034 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639349426 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 89-197 (New Mexico) | Primary |
Provider Name | Benito Gallardo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437278447 PECOS PAC ID: 6709832298 Enrollment ID: I20050330000707 |
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