Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southern Colorado Dermatology Clinic PC

Organization Dermatology Physician · NPI 1548409139

Southern Colorado Dermatology Clinic PC provides Dermatology Physician services in Pueblo, Colorado. Licensed in Colorado. Registered with an NPI since 2009.

Licensed in
CO
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

900 Indiana Ave Ste C
Pueblo, CO 81004-3767
Phone: (719) 564-5544
Fax: (719) 564-2246
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 44146 (CO)

Record details

NPI number1548409139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Krystal Nakamura — Owner · (719) 564-5544
NPI enumeratedFebruary 5, 2009
Last updated in NPPESMay 25, 2021
Certification dateMay 25, 2021
Mailing address900 Indiana Ave Ste C, Pueblo, CO 81004-3767

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