Individual
MANUEL BRANDON PACHECO IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C
Contact information
Practice address
6400 PASEO DEL NORTE NE, ALBUQUERQUE, NM 87113-1718
(505) 596-2100
Mailing address
PO BOX 5122, BERNALILLO, NM 87004-5122
(505) 280-5336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2019-0076
NM
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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