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Organization
SANDIA MOUNTAIN MEDICAL, INC.
Active
Organization
SANDIA MOUNTAIN MEDICAL, INC.
Active
Other names
New Mexico Medical
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA GONZALES (OFFICE MANAGER)
(505) 832-4434
Entity
Organization
Contact information
Practice address
1851 OLD US 66, UNIT 1, EDGEWOOD, NM 87015-6784
(505) 286-2396
(505) 286-2398
Mailing address
12127B HWY 14 N STE 5, CEDAR CREST, NM 87008-9499
(505) 286-2396
(505) 286-2398
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/05/2006
Last updated
05/20/2016
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