| Organization Name: | LEO J RASCHBAUM MDPC |
| NPI Number: | 1881792950 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEOPOLD JOSEPH RASCHBAUM (OWNER) |
| Mailing Address: | 5690 Santa Teresita Building A, Suite 4 Santa Teresa |
| State: | NM US |
| Postal Code: | 88008 |
| Phone Number: | 5055893022 |
| Fax Number: | 5055893021 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 06/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 8588 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |