NPI 1922786763

Gary Lee Sandoval

Practitioner PACE Provider Organization Albuquerque, NM

Practice location

Address: 2111 Raven Ln SW, Albuquerque, NM 87105-4530
Phone: (505) 573-2721

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence 5280 (NM)

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in New Mexico →

Registry record

NPI: 1922786763
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jul 2023
Record last updated: 21 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.