Organization
ST. VINCENT HOSPITAL
Active
Other names
CHRISTUS St. Vincent DeVargas Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE TASSIN (PRESIDENT/CEO)
(505) 820-5201
Entity
Organization
Contact information
Practice address
510 N GUADALUPE ST, SUITE C1, SANTA FE, NM 87501-6510
(505) 913-4660
Mailing address
510 N GUADALUPE ST, SUITE C1, SANTA FE, NM 87501-6510
(505) 913-4660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51038846
—
NM
Enumeration date
11/22/2010
Last updated
02/11/2014
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