Los Alamos Pediatric Clinic
Pediatrics
Los Alamos Pediatric Clinic is a Los Alamos, New Mexico based Pediatric center with medical specialization in
General Pediatrics.
It is located at
3917 West Road, Suite 136, Los Alamos, New Mexico - 87544. They can be contacted on phone at
505-662-9620 and fax number 505-662-0024.
NPI number (Unique professional ID) for Los Alamos Pediatric Clinic is
1245248830 which was assigned by NPPES on 03 Aug, 2006 and it was last updated on 22 Aug, 2020.
Los Alamos Pediatric Clinic license number is
79195 for Pediatrics (208000000X) in New Mexico.
Los Alamos Pediatric Clinic is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Los Alamos Pediatric Clinic basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Los Alamos Pediatric Clinic |
|---|
Business Address:
Los Alamos Pediatric Clinic address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3917 West Road, Suite 136
Los Alamos, NM, 87544
United States |
|---|
| Phone Number : | 505-662-9620 |
|---|
| Fax Number : | 505-662-0024 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1245248830 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 03 Aug, 2006 |
|---|
| Last Updated On : | 22 Aug, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Jacquelineanne Krohn |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 509-662-9620 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Los Alamos Pediatric Clinic are as mentioned. Primary taxonomy code for Los Alamos Pediatric Clinic is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 79195 | NM |
Legacy Identifiers:
Other legacy medical identifiers of Los Alamos Pediatric Clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 11783 | MEDICAID | NM | |
| 10003513 | Other | NM | LOVELACE HEALTH |
| PROVP13573 | Other | NM | MOLINA HEALTHCARE |
| 6693 | Other | NM | HMA NAVAJO NATION |
| NM011552 | Other | NM | BCBS |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 3917 West Road, Suite 136
Los Alamos, NM, 87544
United States |
|---|
| Phone Number : | 505-662-9620 |
|---|
| Fax Number : | 505-662-0024 |
|---|
Business Location:
Patients can refer following map for directions to
Los Alamos Pediatric Clinic practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.