Provider Demographics
NPI:1295350437
Name:CLINICA PARA TODOS
Entity type:Organization
Organization Name:CLINICA PARA TODOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFNP
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:575-644-0480
Mailing Address - Street 1:7345 YORKTOWN AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5070
Mailing Address - Country:US
Mailing Address - Phone:505-681-8295
Mailing Address - Fax:
Practice Address - Street 1:7345 YORKTOWN AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5070
Practice Address - Country:US
Practice Address - Phone:505-681-8295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center