=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578719621
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER G. VIALPANDO M.D. PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2008
-----------------------------------------------------
Last Update Date | 08/08/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 916 INDIANA AVE SUITE #110
-----------------------------------------------------
City | PUEBLO
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81004-3572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-566-9120
-----------------------------------------------------
Fax | 719-566-9121
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 916 INDIANA AVE SUITE #110
-----------------------------------------------------
City | PUEBLO
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81004-3572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-566-9120
-----------------------------------------------------
Fax | 719-566-9121
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | CHRISTOPHER GERARD VIALPANDO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 719-568-9090
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------