Provider Demographics
NPI:1124759873
Name:PINEDA, WILLIAM DANIEL
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DANIEL
Last Name:PINEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S COLORADO BLVD STE 640
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1239
Mailing Address - Country:US
Mailing Address - Phone:316-633-1027
Mailing Address - Fax:
Practice Address - Street 1:400 S COLORADO BLVD STE 640
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1239
Practice Address - Country:US
Practice Address - Phone:303-456-8967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38329225100000X
CO0019127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist