OrganizationActive
Phc-Los Alamos Inc
NPI 1023147097 · Emergency Medical Services (Emergency Medicine) Physician · Los Alamos, NM
Provider details
- NPI number
- 1023147097
- Entity type
- Organization
- Primary specialty
- Emergency Medical Services (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Terrance Dillon, Assistant Secretary(502) 596-7220
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Medical Oncology Physician207RX0202X
Allopathic & Osteopathic Physicians
- Obstetrics & Gynecology Physician207V00000X
Allopathic & Osteopathic Physicians
- Diagnostic Radiology Physician2085R0202X
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
- Urology Physician208800000X
Allopathic & Osteopathic Physicians
Practice location
3917 West Rd
Los Alamos, NM 87544-2275
Phone: (505) 662-3452
Approximate (ZIP-level) locationGet directions
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-4536
Registry dates
- Enumerated
- 2007-03-05
- Last updated
- 2022-04-25
- Certified
- 2022-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.