Provider Demographics
NPI:1043351455
Name:MOUNTAIN VIEW ORTHOPEDICS P C
Entity type:Organization
Organization Name:MOUNTAIN VIEW ORTHOPEDICS P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KOSTA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZINIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-450-2476
Mailing Address - Street 1:9141 GRANT ST
Mailing Address - Street 2:STE #240
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229
Mailing Address - Country:US
Mailing Address - Phone:303-450-2476
Mailing Address - Fax:303-450-2679
Practice Address - Street 1:9141 GRANT ST
Practice Address - Street 2:STE #240
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229
Practice Address - Country:US
Practice Address - Phone:303-450-2476
Practice Address - Fax:303-450-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00952516Medicaid
P00131665OtherRR MEDICARE PIN
70544OtherBSH
70544OtherBSH
G4788Medicare UPIN