Healthcare Provider Details

I. General information

NPI: 1699260604
Provider Name (Legal Business Name): HAMID HADI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N GRAND AVE STE 508
PUEBLO CO
81003-2757
US

IV. Provider business mailing address

1600 N GRAND AVE STE 508
PUEBLO CO
81003-2757
US

V. Phone/Fax

Practice location:
  • Phone: 719-595-7040
  • Fax: 719-595-7045
Mailing address:
  • Phone: 719-595-7040
  • Fax: 719-595-7045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number20A19833
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberDR.0077930
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: