Organization
SANDIA PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER W.H. CHAN M.D. (OWNER/SOLE MEMBER)
(505) 842-0066
Entity
Organization
Contact information
Practice address
801 ENCINO PLACE NE, SUITE D7, ALBUQUERQUE, NM 87102
(505) 842-0066
(505) 842-9325
Mailing address
801 ENCINO PLACE NE, SUITE D7, ALBUQUERQUE, NM 87102
(505) 842-0066
(505) 842-9325
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD2007-0451
NM
Other
Enumeration date
04/01/2010
Last updated
04/15/2015
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