Corazon del Oso Healthcare, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CORAZON DEL OSO HEALTHCARE, LLC

Practice address

3917 West Rd Ste 138
Los Alamos, NM 87544-5307

Phone

(505) 661-9030

Fax

(505) 661-9666

NPI assigned

Oct 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Manuel Jude Baca Sr.

Title

Practice Manager Operator

Phone

(505) 661-9030

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891870051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 ARAGON AVE",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443502",
            "telephone_number": "505-661-9030",
            "fax_number": "505-661-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD STE 138",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875445307",
            "telephone_number": "505-661-9030",
            "fax_number": "505-661-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAZON DEL OSO HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "JUDE",
        "authorized_official_title_or_position": "PRACTICE MANAGER OPERATOR",
        "authorized_official_telephone_number": "505-661-9030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carina Andrea Condado, RPH
• Jacob Connelly
• Josh M Connole, PT, DPT
• Copper Canyon Wellness, LLC
• Corazon Behavioral Health Services Inc
• Clorinda Leann Cordova
• Patrick D. Coriz
• Cottontree Center (Cottonwood Therapy Associate)
• Susan H. Courtney, PHYSICAL THERAPIST
• Emelyn Coussou

• Primary Care Clinic/Center in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Primary Care Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.