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General NPI Number Information
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NPI Number | 1518215029
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Entity Type | Individual
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Provider Name | CHRISTOPHER A PENA O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 6695 W COLFAX AVE
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City | LAKEWOOD
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State | CO
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Zip | 80214-1805
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Country | US
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Telephone | 720-279-2266
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Fax | 303-957-9787
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Provider Business Mailing Address
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Address Line | 2221 E BIJOU ST STE 120
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-8009
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Country | US
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Telephone | 719-576-1850
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Fax | 719-955-3470
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2677
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0003255
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License Number State | CO
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