Provider Demographics
NPI:1932318854
Name:PERALTO, MARCI L K (MD)
Entity type:Individual
Prefix:DR
First Name:MARCI
Middle Name:L K
Last Name:PERALTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SUPERIOR DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8656
Mailing Address - Country:US
Mailing Address - Phone:303-241-7656
Mailing Address - Fax:
Practice Address - Street 1:3 SUPERIOR DR STE 400
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8656
Practice Address - Country:US
Practice Address - Phone:303-673-1440
Practice Address - Fax:303-673-1360
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49772207V00000X
HI18377207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91652570Medicaid
CO21892OtherKAISER COMMERCIAL NUMBER
COCOAAA2093Medicare PIN