Basic Information
| Provider Information | |||||||||
| NPI: | 1184682742 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALIJANI | ||||||||
| FirstName: | ALIREZA | ||||||||
| MiddleName: | TODD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8101 E LOWRY BLVD STE 230 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802307195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032144500 | ||||||||
| FaxNumber: | 3032144571 | ||||||||
| Practice Location | |||||||||
| Address1: | 11960 LIONESS WAY STE 260 | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033449090 | ||||||||
| FaxNumber: | 7208951121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0106X | DR.0040229 | CO | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 207X00000X | 40229 | CO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 04375025 | 05 | CO | MEDICAID |