Healthcare Provider Details

I. General information

NPI: 1265508543
Provider Name (Legal Business Name): VA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

1055 CLERMONT ST
DENVER CO
80220-3808
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-2863
  • Fax:
Mailing address:
  • Phone: 303-393-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number19874
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number19874
License Number StateCO

VIII. Authorized Official

Name: DR. WILLIAM M PELANDER
Title or Position: SURGEON
Credential: M.D.
Phone: 303-393-2863