Los Alamos Medical Care Clinic LTD

Organization Active NPI Multi-Specialty Clinic/Center · Los Alamos, NM

NPI 1801816293 · NPPES record last updated Feb 20, 2020

Key facts

NPI
1801816293
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
LOS ALAMOS MEDICAL CARE CLINIC LTD
Practice address
3917 West Rd
Suite 150
Los Alamos, NM 87544
Phone
(505) 662-4351
Fax
(505) 662-2932
NPI assigned
Jul 20, 2006
Organization subpart
No

Authorized official

Name
Claudette Medina
Title
Office Manager
Phone
(505) 662-4351

Practitioners 11

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040322001618 NM Part B Supplier - Clinic/Group Practice 4284525007 Receives reassigned benefits from 11 practitioners
Practice locations: Los Alamos, NM

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207K00000X
Dermatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207N00000X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

3917 West Rd
Suite 150
Los Alamos, NM 87544

Mailing address

3917 West Rd
Suite 150
Los Alamos, NM 87544
Phone (505) 662-4351

Other providers in Los Alamos, NM

All providers in Los Alamos, NM · Multi-Specialty Clinic/Center in New Mexico

Sources for this page

Verify at the official NPI Registry.