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1770119679
KALU B LONG
ESPANOLA, NM
NPI
1770119679
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NM MD2023-1039)
Enumeration Date
2020-03-23
Last Update Date
2023-08-09
Business Address
KALU B LONG MD
1010 SPRUCE ST
ESPANOLA, NM 87532-2724
Phone number: 505-753-7111
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Mailing Address
KALU B LONG MD
PO BOX 26666 PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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