Healthcare Provider Details

I. General information

NPI: 1003273293
Provider Name (Legal Business Name): CORNERSTONE HEALTH COMMUNITY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 E ORCHARD RD STE 306
CENTENNIAL CO
80111-1724
US

IV. Provider business mailing address

7180 E ORCHARD RD STE 306
CENTENNIAL CO
80111-1724
US

V. Phone/Fax

Practice location:
  • Phone: 720-452-7420
  • Fax: 720-446-4174
Mailing address:
  • Phone: 720-452-7420
  • Fax: 720-446-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR0051449
License Number StateCO

VIII. Authorized Official

Name: CHRISTOPHER JON MOTE SR.
Title or Position: PRESIDENT
Credential: DO
Phone: 303-770-4227