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NPI Code Detail

MEDICARE: DR. PAUL FRUTOS DO

MEDICARE: DR. PAUL FRUTOS DO
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
1207P00000XEmergency Medicine PhysicianDR.0052668CO
2207P00000XEmergency Medicine Physician18713MS
3207P00000XEmergency Medicine Physician20A15347CA

General Provider Information

NPI Number : 1639228059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL FRUTOS DO
Provider Business Mailing Address
First Line : 400 W 16TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2745
Country : US
Telephone Number : 719-584-4306
Fax Number : 719-595-7886
Provider Business Practice Location Address
First Line : 400 W 16TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2745
Country : US
Telephone Number : 719-584-4306
Fax Number : 719-595-7886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 04/24/2026

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Directions to “ DR. PAUL FRUTOS DO” Practice Location

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