Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Other names
Moreno Valley Healthcare Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GARCIA (VP REGIONAL OPERATIONS)
(505) 923-5339
Entity
Organization
Contact information
Practice address
11 ELLIOTT BARKER LANE, ANGEL FIRE, NM 87710
(505) 337-3301
(505) 337-3991
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
2005510
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q7392
—
NM
Enumeration date
12/13/2005
Last updated
08/08/2010
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