Organization
LA FAMILIA MEDICAL CENTER
Active
Other names
La Familia Health
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON VANESSA VAN PELT (CEO)
(505) 982-4425
Entity
Organization
Contact information
Practice address
1035 ALTO ST, SANTA FE, NM 87501-2406
(505) 982-4425
(505) 982-8440
Mailing address
1035 ALTO ST, SANTA FE, NM 87501-2406
(505) 982-4425
(505) 982-1263
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
321804
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F8002
—
NM
Enumeration date
08/10/2006
Last updated
01/13/2025
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