Individual
DANIEL PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 PASEO DEL PUEBLO SUR, TAOS, NM 87571-6070
(575) 758-7430
Mailing address
12025 MANITOBA DR NE, ALBUQUERQUE, NM 87111-2749
(575) 770-4024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NM
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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