Organization
CENTENNIAL VALLEY PEDIATRICS, P.C.
Active
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
Update your record
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