Organization
SOUTHERN COLORADO ANESTHESIA PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R SANDOVAL MD (MANAGING PARTNER)
(719) 214-2180
Entity
Organization
Contact information
Practice address
4100 JERRY MURPHY RD, PUEBLO, CO 81001-1046
(719) 214-2180
Mailing address
4100 JERRY MURPHY RD, PUEBLO, CO 81001-1046
(719) 214-2180
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DR-38609
CO
Other
Enumeration date
12/19/2008
Last updated
12/19/2008
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