Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 2001139 | NM |
NPI | 1043304413 |
---|---|
Provider Name | Arnel Anthony S Bobadilla |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Clovis, NM 88101-2011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 16/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34956557 | (05) | NM |
H74446 | (02) |