Individual
JACQUELINE MITONGO KABONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2222 NORTH NEVADA AVENUE, SUITE 4001, COLORADO SPRINGS, CO 80907
(719) 636-9393
(719) 636-9087
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
(800) 953-0104
(303) 765-6670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DR.0057178
CO
208M00000X
Hospitalist Physician
Primary
DR.0057178
CO
Other
Enumeration date
04/02/2013
Last updated
01/30/2024
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