Provider Demographics
NPI:1326440074
Name:SANTA FE MEDICAL GROUP
Entity Type:Organization
Organization Name:SANTA FE MEDICAL GROUP
Other - Org Name:VALLEY FIRST CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-338-3851
Mailing Address - Street 1:7601 JEFFERSON ST NE
Mailing Address - Street 2:STE 340
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4494
Mailing Address - Country:US
Mailing Address - Phone:505-338-3851
Mailing Address - Fax:505-338-3859
Practice Address - Street 1:411 S SANTA CLARA BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-9477
Practice Address - Country:US
Practice Address - Phone:505-747-6939
Practice Address - Fax:505-747-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00046233Medicaid
NM00046233Medicaid