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General NPI Number Information
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NPI Number | 1366492480
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Entity Type | Individual
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Provider Name | PAUL D RASTRELLI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 3155 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8703
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Country | US
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Telephone | 719-630-3937
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Fax | 719-635-3578
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Provider Business Mailing Address
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Address Line | 3155 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8703
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Country | US
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Telephone | 719-630-3937
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Fax | 719-635-3578
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 36999
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License Number State | CO
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