Organization
SAN JUAN REGIONAL MEDICAL CENTER INC
Active
Organization
SAN JUAN REGIONAL MEDICAL CENTER INC
Active
Parent organization
SAN JUAN REGIONAL MEDICAL CENTER INC
Other names
SAN JUAN PEDIATRICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAN JUAN REGIONAL MEDICAL CENTER INC
Authorized official
KIM BYRD (ADMINISTRATIVE DIRECTOR OF REIMBURS)
(505) 609-2258
Entity
Organization
Contact information
Practice address
407 S SCHWARTZ AVE, SUITE 102, FARMINGTON, NM 87401-5925
(505) 609-6700
(505) 609-6701
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000S8021
—
NM
Enumeration date
10/03/2006
Last updated
07/16/2025
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