Organization
CLOVIS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT M KWAN MD (OWNER)
(575) 762-2207
Entity
Organization
Contact information
Practice address
1820 W 21ST ST, CLOVIS, NM 88101-4024
(575) 762-2207
(575) 762-7108
Mailing address
1820 W 21ST ST, CLOVIS, NM 88101-4024
(575) 762-2207
(575) 762-7108
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3042
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000F8949
—
NM
01
—
490005150
RAILROAD MEDICARE
NM
Enumeration date
11/08/2005
Last updated
04/04/2016
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