Gonzalo A Diaz
Internal Medicine, Sleep Medicine in Los Alamos, NM. Organization (NPI-2).
NPI number1366089237
StatusActive
Last updated in NPPESDec 20, 2019
Details
- NPI
- 1366089237
- Entity type
- Organization (NPI-2)
- Legal business name
- Gonzalo A Diaz
- Organization subpart
- Yes
- Enumeration date
- Dec 10, 2019
- Certification date
- Dec 20, 2019
- Last updated
- Dec 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RS0012X | Internal Medicine, Sleep Medicine | – | – | Yes |
Other names
- Los Alamos (Doing Business As)
Practice location
3917 West RdLos Alamos, NM 87544-2275
Phone 915-779-7378 · Fax 915-779-2822
Mailing address
4305 N Mesa St Ste BEl Paso, TX 79902-1124
Phone 915-778-7378 · Fax 915-779-2822
Authorized official
Gonzalo A Diaz
Owner
9157797378
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