Provider Demographics
NPI:1588993257
Name:EASTLUND, DAVID FOSTER (PAC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:FOSTER
Last Name:EASTLUND
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2512
Mailing Address - Country:US
Mailing Address - Phone:720-274-0341
Mailing Address - Fax:720-274-0367
Practice Address - Street 1:3277 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2512
Practice Address - Country:US
Practice Address - Phone:720-274-0341
Practice Address - Fax:720-274-0367
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2932363A00000X, 363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical