Individual
MICHAEL CALABAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
85 WEST HWY 22, SANTO DOMINGO PUEBLO, NM 87052
(505) 465-3060
Mailing address
PO BOX 340, SANTO DOMINGO PUEBLO, NM 87052-0340
(505) 465-3060
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
S3-1211
NM
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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