Individual
CHRISTOPHER GAVALDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
PRESBYTERIAN HEART GROUP (PHG), 201 CEDAR SE SUITE 7600, ALBUQUERQUE, NM 87106
(505) 563-2500
(505) 563-2603
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
PA2003-0014
NM
363A00000X
Physician Assistant
Primary
PA2003-0014
NM
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64276210
—
NM
Enumeration date
10/04/2006
Last updated
08/06/2010
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