Davita Medical Group

LBN: Optumcare New Mexico, Llc
Davita Medical Group is an health care organization with primary practice located at 5400 Gibson Blvd Se , Albuquerque NM 87108-4729. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as the primary health care specialty. Optumcare New Mexico, Llc can be contacted via phone (505) 262-7026, or through Liethen, John G via phone (952) 205-6262.

Contact Information

Primary practice address
5400 Gibson Blvd Se Albuquerque NM 87108-4729
Phone: (505) 262-7026
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Liethen, John G
Phone: (952) 205-6262

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 01759 New Mexico

Profile Details

NPI number 1326338963
LBN Legal business name Optumcare New Mexico, Llc
DBA Doing business as Davita Medical Group
Authorized official Liethen, John G
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2011
Last updated Aug 22nd, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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