Otero, Charles Daniel

Otero, Charles Daniel is an individual health care provider with primary practice located at 701 Arizona St Suite A, Clovis NM 88101-2110. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Otero, Charles Daniel can be contacted via phone (575) 742-3033.

Contact Information

Primary practice address
701 Arizona St Suite A Clovis NM 88101-2110
Phone: (575) 742-3033
Fax: (575) 742-1133
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 93-PA01 New Mexico

Profile Details

NPI number 1255375903
LBN Legal business name Otero, Charles Daniel
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Dec 27th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255375903 NPPES
New Mexico MEDICAID 97903

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