Organization
KENNETH P. GOLDBLUM, M.D., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH P. GOLDBLUM M.D. (PRESIDENT)
(505) 205-2917
Entity
Organization
Contact information
Practice address
26 TIERRA MONTE ST NE, ALBUQUERQUE, NM 87122-2102
(505) 453-6554
Mailing address
26 TIERRA MONTE ST NE, ALBUQUERQUE, NM 87122-2102
(505) 453-6554
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
71-145
NM
Other
Enumeration date
10/30/2015
Last updated
10/30/2015
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