Individual
LORETTA GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10151 MONTGOMERY BLVD NE BLDG 1, ALBUQUERQUE, NM 87111-3670
(505) 855-5503
(505) 855-5533
Mailing address
10151 MONTGOMERY BLVD NE BLDG 1, ALBUQUERQUE, NM 87111-3670
(505) 855-5503
(505) 855-5533
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2023-0232
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2023-0232
LICENSE
NM
Enumeration date
10/22/2021
Last updated
10/17/2025
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