Provider Demographics
NPI:1245693266
Name:LAS CRUCES INTERNISTS, LLC
Entity type:Organization
Organization Name:LAS CRUCES INTERNISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIDANA-PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-222-0815
Mailing Address - Street 1:3825 FOOTHILLS RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-5144
Mailing Address - Country:US
Mailing Address - Phone:575-222-0815
Mailing Address - Fax:575-222-0817
Practice Address - Street 1:3825 FOOTHILLS RD STE B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5144
Practice Address - Country:US
Practice Address - Phone:575-222-0815
Practice Address - Fax:575-222-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty