Organization
LOS ALAMOS PHYSICIAN PRACTICES LLC
Active
Organization
LOS ALAMOS PHYSICIAN PRACTICES LLC
Active
Other names
LOS ALAMOS SURGICAL ASSOC- UROLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MANGUM (DIRECTOR)
(575) 521-5277
Entity
Organization
Contact information
Practice address
3917 WEST RD, SUITE 137, LOS ALAMOS, NM 87544-2275
(575) 661-8500
Mailing address
PO BOX 129, LOS ALAMOS, NM 87544-0129
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD2008-0654
NM
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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