| The 5th Element Medical Practice Pc | |
|
5300 Sequoia Rd Nw Suite 101 Albuquerque NM 87120-1283 | |
| (505) 839-6825 | |
| Not Available |
| Full Name | The 5th Element Medical Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 5300 Sequoia Rd Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Trang M Tran (OWNER) |
| Authorized Official Contact | 5058396825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The 5th Element Medical Practice Pc 5300 Sequoia Rd Nw Suite 101 Albuquerque NM 87120-1283 Ph: (505) 839-6825 | The 5th Element Medical Practice Pc 5300 Sequoia Rd Nw Suite 101 Albuquerque NM 87120-1283 Ph: (505) 839-6825 |
| NPI Number | 1225396138 |
|---|---|
| Provider Enumeration Date | 04/27/2012 |
| Last Update Date | 12/13/2012 |
| Medicare PECOS PAC ID | 1355593732 |
|---|---|
| Medicare Enrollment ID | O20121211000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225396138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD2008-0787 (* (Not Available)) | Primary |
| Provider Name | Trang M Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265683379 PECOS PAC ID: 4183773047 Enrollment ID: I20090522000462 |
| Provider Name | Kristine Yvette Uy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851931174 PECOS PAC ID: 1355772047 Enrollment ID: I20200513001501 |
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