Mena, Juan Carlos

Mena, Juan Carlos is an individual health care provider with primary practice located at 4411 The 25 Way Ne Suite 150, Albuquerque NM 87109-5857. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mena, Juan Carlos can be contacted via phone (505) 332-6900.

Contact Information

Primary practice address
4411 The 25 Way Ne Suite 150 Albuquerque NM 87109-5857
Fax: (505) 332-6921
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 20050716 New Mexico

Profile Details

NPI number 1184696387
LBN Legal business name Mena, Juan Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Mar 12th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184696387 NPPES
New Mexico Other 600521002 MEDICARE IDTF
New Mexico Other 800521226 MEDICARE IDTF
New Mexico Other 2258272 MEDICARE IDTF
New Mexico Other 700521102 MEDICARE IDTF
New Mexico MEDICAID 45138 MEDICARE IDTF
New Mexico MEDICAID 52713 MEDICARE IDTF
New Mexico MEDICAID 68071019 MEDICARE IDTF
New Mexico MEDICAID 1492060 MEDICARE IDTF
New Mexico MEDICAID L0634 MEDICARE IDTF

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