Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PUEBLO SPORTS AND FAMILY MEDICINE PLLC
Active
Organization
PUEBLO SPORTS AND FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAKESH KHOSLA MD (PRESIDENT)
(719) 544-2740
Entity
Organization
Contact information
Practice address
1315 FORTINO BLVD STE C, PUEBLO, CO 81008-1981
(719) 544-2740
Mailing address
1315 FORTINO BLVD STE C, PUEBLO, CO 81008-1981
(719) 544-2740
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
543004
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004910
PA NUMBER
CO
05
—
1268788
—
CO
Enumeration date
04/16/2018
Last updated
04/22/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up