| Sunshine Medical Group Pllc | |
|
1600 N Grand Ave Suite 120 Pueblo CO 81003-2700 | |
| (719) 545-9292 | |
| (719) 545-9191 |
| Full Name | Sunshine Medical Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 N Grand Ave, Pueblo, Colorado |
| Authorized Official Name and Position | Indira Kedlaya (OWNER PHYSICIAN) |
| Authorized Official Contact | 7195459292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunshine Medical Group Pllc 1600 N Grand Ave Suite 120 Pueblo CO 81003-2700 Ph: (719) 545-9292 | Sunshine Medical Group Pllc 1600 N Grand Ave Suite 120 Pueblo CO 81003-2700 Ph: (719) 545-9292 |
| NPI Number | 1770788770 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 01/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770788770 | NPI | - | NPPES |
| PE2582 | Other | RR MEDICARE | |
| 73637556 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 44387 (Colorado) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 44387 (Colorado) | Secondary |
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