Organization
PUEBLO PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUAZI R PARVIN MD (MANAGER)
(719) 404-3665
Entity
Organization
Contact information
Practice address
900 INDIANA AVE, SUITE D, PUEBLO, CO 81004-3766
(719) 404-3672
(719) 564-0374
Mailing address
200 S SANTA FE AVE, SUITE 500, PUEBLO, CO 81003-4270
(719) 296-5842
(719) 542-0746
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
43488
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851378749
NPI INDIVIDUAL
CO
05
—
88981541
—
CO
Enumeration date
09/14/2010
Last updated
12/08/2010
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