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General NPI Number Information
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NPI Number | 1871018085
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Entity Type | Organization
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Legal Business Name | PINNACLE PEDIATRICS AND INTERNAL MEDICINE PROFESSIONAL LLC
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 13648 ORCHARD PKWY UNIT 900
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City | WESTMINSTER
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State | CO
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Zip | 80023-9263
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Country | US
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Telephone | 816-590-9456
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Fax |
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Provider Business Mailing Address
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Address Line | 13648 ORCHARD PKWY UNIT 900
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City | WESTMINSTER
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State | CO
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Zip | 80023-9263
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Country | US
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Telephone | 720-239-7725
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WALTER WILSON
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Credential |
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Telephone | 720-223-6177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 53133
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License Number State | CO
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