Provider Demographics
NPI:1336121813
Name:VALL-SPINOSA, BARBARA LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LEIGH
Last Name:VALL-SPINOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 CENTRO FAMILIAR BLVD SW
Mailing Address - Street 2:FIRST CHOICE COMMUNITY HEALTHCARE
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105
Mailing Address - Country:US
Mailing Address - Phone:505-831-2534
Mailing Address - Fax:505-831-4123
Practice Address - Street 1:1300 N DUTTON AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-7112
Practice Address - Country:US
Practice Address - Phone:707-459-6861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR38126207Q00000X
CAA063431207Q00000X
NMMD20040517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G97583Medicare UPIN