Organization
GRAY PEARLS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN KIM M.D. (SOLE MEMBER/PHYSICIAN)
(505) 506-1984
Entity
Organization
Contact information
Practice address
2506 TRAMWAY TERRACE CT NE, ALBUQUERQUE, NM 87122-2317
(505) 506-1984
Mailing address
2506 TRAMWAY TERRACE CT NE, ALBUQUERQUE, NM 87122-2317
(505) 506-1984
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
97-289
NM
Other
Enumeration date
04/02/2016
Last updated
04/02/2016
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