Individual
MARIO LEYBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-6200
(505) 727-9590
Mailing address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-6200
(505) 727-9590
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
76329
AZ
208600000X
Surgery Physician
Primary
MD2009-0523
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68401051
—
NM
Enumeration date
06/05/2007
Last updated
09/14/2018
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