Healthcare Provider Details
I. General information
NPI: 1891312336
Provider Name (Legal Business Name): CASTLE PINES PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2020
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7501 VILLAGE SQUARE DR STE 207
CASTLE PINES CO
80108-3708
US
IV. Provider business mailing address
558 E CASTLE PINES PKWY UNIT B4-157
CASTLE PINES CO
80108-4608
US
V. Phone/Fax
- Phone: 720-779-1991
- Fax: 720-779-1992
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMAIYA
JAMES
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 720-779-1991