Organization
LIFE ENHANCEMENT SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARMIN FOGHI M.D. PH.D (CARDIOLOGIST)
(505) 892-0402
Entity
Organization
Contact information
Practice address
8200 CARMEL AVE NE, STE. 102, ALBUQUERQUE, NM 87122-2941
(505) 892-0402
(505) 892-5544
Mailing address
1740 GRANDE BLVD SE, STE. C & D, RIO RANCHO, NM 87124-1799
(505) 892-0402
(505) 892-5544
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD2005-0713
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA100865
MEDICARE PTAN
NM
Enumeration date
03/19/2014
Last updated
03/19/2014
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