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General NPI Number Information
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NPI Number | 1386901379
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Entity Type | Organization
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Legal Business Name | DIANE H PELTO, MD, PC
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/16/2012
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Provider Practice Location Address
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Address Line | 35 1ST ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3623
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Country | US
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Telephone | 719-328-1967
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Fax |
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Provider Business Mailing Address
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Address Line | 35 1ST ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3623
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Country | US
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Telephone | 719-328-1967
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DIANE H PELTO
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Credential | MD
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Telephone | 719-328-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DR 35998
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License Number State | CO
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