Basic Information
| Provider Information | |||||||||
| NPI: | 1306233713 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEDBERG | ||||||||
| FirstName: | CALEB | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 S UNION BLVD STE 800 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802282213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039882680 | ||||||||
| FaxNumber: | 3039868057 | ||||||||
| Practice Location | |||||||||
| Address1: | 165 S UNION BLVD STE 800 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039882680 | ||||||||
| FaxNumber: | 3039868057 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2015 | ||||||||
| LastUpdateDate: | 08/21/2018 | ||||||||
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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 | 207R00000X | PG172307 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.