Provider Demographics
NPI:1134721145
Name:PEAK GASTROENTEROLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:PEAK GASTROENTEROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL / MEDICAL DR
Authorized Official - Prefix:
Authorized Official - First Name:BHAKTASHARAN
Authorized Official - Middle Name:CHIMANBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-636-1201
Mailing Address - Street 1:2920 N CASCADE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6262
Mailing Address - Country:US
Mailing Address - Phone:719-636-1201
Mailing Address - Fax:719-955-0986
Practice Address - Street 1:595 CHAPEL HILLS DR STE 303
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1057
Practice Address - Country:US
Practice Address - Phone:719-636-1201
Practice Address - Fax:719-955-0986
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAK GASTROENTEROLOGY ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty