David Seyedsadr

Individual provider Active NPI Case Manager/Care Coordinator · Tijeras, NM

NPI 1134965320 · NPPES record last updated Jul 8, 2024

Key facts

NPI
1134965320
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1 Camino Oro CT
Tijeras, NM 87059-7924
Phone
(505) 274-8534
Fax
(855) 610-2330
NPI assigned
Jul 8, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1 Camino Oro CT
Tijeras, NM 87059-7924

Mailing address

90 McGinnis Rd
Tijeras, NM 87059-7925
Phone (859) 312-5506

Other providers in Tijeras, NM

All providers in Tijeras, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.