Organization
PEDIATRIC GASTROENTEROLOGY OF COLORADO SPRINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERIN YAZDI (PRACTICE MANAGER)
(719) 590-1000
Entity
Organization
Contact information
Practice address
2925 PROFESSIONAL PL STE 103, COLORADO SPRINGS, CO 80904-8125
(719) 590-1000
(719) 590-1005
Mailing address
2925 PROFESSIONAL PL STE 103, COLORADO SPRINGS, CO 80904-8125
(719) 590-1000
(719) 590-1005
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35668
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47329769
—
CO
Enumeration date
05/20/2007
Last updated
09/18/2012
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