Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G7094 | TX |
NPI | 1245283548 |
---|---|
Provider Name | Dr. John H. Peloza |
First Address | Vail, CO 81657-5058 |
Second Address | Vail, CO 81657-5058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 16/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E15316 | (02) | TX |