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Organization

CENTENNIAL VALLEY PEDIATRICS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELLEN BOYD (ADMINISTRATOR)
(303) 666-7337
Entity
Organization

Contact information

Practice address
469 STATE HIGHWAY 7 STE 300, BROOMFIELD, CO 80023-8965
(303) 666-7337
Mailing address
469 STATE HIGHWAY 7 STE 300, BROOMFIELD, CO 80023-8965
(303) 666-7337
(303) 666-7379

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04014791
CO
01
CEJ1808
BLUE CROSS BLUE SHIELD
CO
Enumeration date
01/28/2021
Last updated
02/03/2021
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