GLENDA LOPEZ PORTILLO

ALBUQUERQUE, NM
NPI1497287080
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: NM  MD2020-0767)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-04-01
Last Update Date2021-06-24
Business Address
GLENDA LOPEZ PORTILLO MD
401 SAN MATEO BLVD SE
ALBUQUERQUE, NM 87108-2921
Phone number: 505-462-7333
Mailing Address
GLENDA LOPEZ PORTILLO MD
PO BOX 26666 PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770