Provider Demographics
NPI:1962417410
Name:BAGGA, ARLENE (MD)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:BAGGA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8801 HORIZON BLVD NE STE 360
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1563
Mailing Address - Country:US
Mailing Address - Phone:505-246-2622
Mailing Address - Fax:505-715-5334
Practice Address - Street 1:5757 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3566
Practice Address - Country:US
Practice Address - Phone:505-888-5757
Practice Address - Fax:505-875-0160
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2024-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2005-566207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM6U5171OtherPTAN
NM56031033Medicaid