Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Phc-Los Alamos Inc

Organization Emergency Medical Services (Emergency Medicine) Physician · NPI 1023147097

Phc-Los Alamos Inc is an Emergency Medical Services (Emergency Medicine) Physician in Los Alamos, New Mexico. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
6
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3917 W Rd
Los Alamos, NM 87544-2275
Phone: (505) 662-3452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medical Services (Emergency Medicine) Physician (primary) Taxonomy 207PE0004X
Medical Oncology Physician Taxonomy 207RX0202X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Diagnostic Radiology Physician Taxonomy 2085R0202X
Surgery Physician Taxonomy 208600000X
Urology Physician Taxonomy 208800000X

Record details

NPI number1023147097
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Terrance Dillon — Assistant Secretary · (502) 596-7220
NPI enumeratedMarch 5, 2007
Last updated in NPPESApril 25, 2022
Certification dateApril 25, 2022
Mailing address330 Seven Springs Way, Brentwood, TN 37027-4536