MEDICARE: DANIELLE PEINDL PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA.0006625	CO
2	208000000X	Pediatrics Physician	PA.0006625	CO
3	208600000X	Surgery Physician	PA.0006625	CO

General Provider Information

NPI Number	:	1912528746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE PEINDL PAC

Provider Business Mailing Address
First Line	:	360 W PARK DR STE 201
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1619
Country	:	US
Telephone Number	:	970-609-7337
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 W PARK DR STE 201
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1619
Country	:	US
Telephone Number	:	970-609-7337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	11/06/2025

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Directions to “ DANIELLE PEINDL PAC” Practice Location

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