Organization
GREEN MOUNTAIN PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCINE PASTON MD (MANAGING PARTNER)
(303) 936-7415
Entity
Organization
Contact information
Practice address
255 UNION BLVD, SUITE 120, LAKEWOOD, CO 80228-1810
(303) 936-7415
Mailing address
255 UNION BLVD, SUITE 120, LAKEWOOD, CO 80228-1810
(303) 936-7415
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04006326
—
CO
01
—
GRA28161
BLUE SHIELD
CO
Enumeration date
07/16/2006
Last updated
08/22/2020
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