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General NPI Number Information
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NPI Number | 1699190215
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Entity Type | Individual
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Provider Name | PETER GUANDO JR. P.A
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Gender | Male
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 13631 COLORADO BLVD
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City | THORNTON
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State | CO
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Zip | 80602-7051
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Country | US
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Telephone | 303-252-2960
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Fax | 303-252-2964
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Provider Business Mailing Address
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Address Line | 13631 COLORADO BOULEVARD
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City | THORNTON
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State | CO
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Zip | 80602
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Country | US
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Telephone | 303-252-2960
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Fax | 303-252-2964
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0004915
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License Number State | CO
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