Provider Demographics
NPI:1336438142
Name:MOUNTAIN PEDIATRICS, P.C.
Entity type:Organization
Organization Name:MOUNTAIN PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERI
Authorized Official - Middle Name:J
Authorized Official - Last Name:LESWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-375-5798
Mailing Address - Street 1:31955 CASTLE CT
Mailing Address - Street 2:SUITE 2 SOUTH
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-3507
Mailing Address - Country:US
Mailing Address - Phone:720-375-5798
Mailing Address - Fax:
Practice Address - Street 1:31955 CASTLE CT
Practice Address - Street 2:SUITE 2 SOUTH
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-3507
Practice Address - Country:US
Practice Address - Phone:720-375-5798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty