Basic Information
Provider Information | |||||||||
NPI: | 1295016228 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | UNIVERSITY OF COLORADO DENVER HOSPITAL | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1057 MARION ST | ||||||||
Address2: | AP #8 | ||||||||
City: | DENVER | ||||||||
State: | CO | ||||||||
PostalCode: | 802183034 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3035893010 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 12631 E 17TH AVE | ||||||||
Address2: |   | ||||||||
City: | AURORA | ||||||||
State: | CO | ||||||||
PostalCode: | 800452527 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3037242052 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/04/2011 | ||||||||
LastUpdateDate: | 09/04/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | ALVERO | ||||||||
AuthorizedOfficialFirstName: | RUBEN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | ASSOCIATE PROFESSOR | ||||||||
AuthorizedOfficialTelephone: | 7208481833 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | DR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NW0100X |   |   | Y |   | Hospitals | General Acute Care Hospital | Women |
No ID Information.