NPIMap

Organization Active NPI

Gonzalo a Diaz

Doing business as Los Lunas Sleep Center

  • Sleep Medicine (Internal Medicine) Physician
  • Los Lunas, NM
National Provider Identifier
1871130732
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
GONZALO A DIAZ
Doing business as
Los Lunas Sleep Center
Practice address
1204 Main St NE Ste a
Los Lunas, NM 87031-7423
Phone
(915) 779-7378
Fax
(915) 779-2822
NPI assigned
Dec 10, 2019
Last updated
Dec 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
GONZALO A DIAZAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Authorized official

Name
Gonzalo A Diaz, MDNPI 1134129240
Title
Owner
Phone
(915) 779-7378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU Primary

Addresses

Primary practice location

1204 Main St NE Ste a
Los Lunas, NM 87031-7423

Mailing address

4305 N Mesa St Ste B
El Paso, TX 79902-1124
Phone (915) 779-7378

Other identifiers 1

IdentifierTypeStateIssuer
79570054MedicaidNM

Other names 1

  • Los Lunas Sleep Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gonzalo a Diaz10 organizations share this tax ID, including this one
Part of
Gonzalo a Diaz

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1155 Commerce Dr
Ste G
Las Cruces, NM 88011
Phone (575) 647-5337

2000 Lomaland Dr
El Paso, TX 79935
Phone (915) 875-1801

4305 N Mesa St
Ste B
El Paso, TX 79902
Phone 91577973781024

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1871130732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 N MESA ST STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021124",
            "telephone_number": "915-779-7378",
            "fax_number": "915-779-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST NE STE A",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317423",
            "telephone_number": "915-779-7378",
            "fax_number": "915-779-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALO A DIAZ",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GONZALO A DIAZ",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-779-7378",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79570054",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Lunas Sleep Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Los Lunas Sleep Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.