Diana Medina PA-C
Physician Assistant in Santa Fe, NM(View on Map)
Full Name
Diana Medina PA-C
NPI Number
1104873082
NPI Type
Individual Provider
Gender
Female
Enumeration Date
05/27/2006
Specialties
(Taxonomies)Licenses
State
New Mexico
License Number
91-PA07
Contact
Information
Purpose
Mailing
Location
Address
2025 GALISTEO ST
2025 GALISTEO ST
City
Santa Fe
Santa Fe
State
NM
NM
Postal Code
87505-2101
87505-2101
Country
US
US
Telephone Number
(505) 995-4901
(505) 995-4901
Identifiers
Identifier
QMYPR0068422
201006707
98151
Identifier State
Unknown
Unknown
NM
Identifier Issuer
MOLINA
PRESBYTERIAN HEALTH PLANS
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/26/2013