Basic Information
| Provider Information | |||||||||
| NPI: | 1164724639 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUE ORTHOPEDICS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 W 144TH AVE | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034696790 | ||||||||
| FaxNumber: | 3034696794 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 W 144TH AVE | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034696790 | ||||||||
| FaxNumber: | 3034696794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2010 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| AuthorizedOfficialLastName: | BAGLEY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 3034696790 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 45154 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 6588510001 | 01 | CO | MEDICARE DME | OTHER | 89103769 | 05 | CO | MEDICAID |