Luz de Vida LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

240 Issued in NM

Legal business name

LUZ DE VIDA LLC

Practice address

705 Middle San Pedro
Espanola, NM 87532

Phone

(505) 747-7242

Fax

(505) 747-7242

NPI assigned

Jul 24, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paloma Terese Blaire, DO MNPI 1245391556

Title

Owner Physician

Phone

(505) 747-7242

Specialties & licenses 1

Addresses

Other names 1

• Luz de Vida Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paloma Terese Blaire, DOM

  • Acupuncturist
  • Espanola, NM
  • NPI 1245391556
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1063677516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2901",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "87532",
            "telephone_number": "505-747-7242",
            "fax_number": "505-747-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MIDDLE SAN PEDRO",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "87532",
            "telephone_number": "505-747-7242",
            "fax_number": "505-747-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZ DE VIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "BLAIRE",
        "authorized_official_first_name": "PALOMA",
        "authorized_official_middle_name": "TERESE",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "505-747-7242",
        "authorized_official_credential": "DO M"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luz de Vida",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Antonia Lujan, LSAA
• Carmen Lujan
• Suzanne Lujan
• Leticia A Luketich Martinez, CNP
• Lisa Luttbeg, MA
• Elizabeth Lykins, LMHC
• Jessie Jean Mackenzie, LMFT
• Feral A Macloud, DOM
• Frances M Madrid, R.N.
• Marissa M Maestas, CSW

• Acupuncturist in Espanola, NM
• Providers in Espanola, NM by specialty
• Acupuncturist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.