MEDICARE: PEAK FAMILY MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	PE659951	OTHER	CO	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1326218553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK FAMILY MEDICINE PC

Provider Business Mailing Address
First Line	:	4500 E 9TH AVE
Second Line	:	STE 320
City	:	DENVER
State	:	CO
Zip	:	80220-3922
Country	:	US
Telephone Number	:	303-322-7325
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 E 9TH AVE
Second Line	:	STE 320
City	:	DENVER
State	:	CO
Zip	:	80220-3922
Country	:	US
Telephone Number	:	303-322-7325
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JONATHAN ZONCA
Credential	:	M.D.
Telephone Number	:	303-322-7325

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	03/05/2008

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Directions to “PEAK FAMILY MEDICINE PC ” Practice Location

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