Provider Demographics
NPI:1487537205
Name:PINTOR, KENNETH
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:PINTOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9121 AZTEC RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-4633
Mailing Address - Country:US
Mailing Address - Phone:575-779-1064
Mailing Address - Fax:
Practice Address - Street 1:1316 APACHE AVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3212
Practice Address - Country:US
Practice Address - Phone:310-721-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker