Basic Information
| Provider Information | |||||||||
| NPI: | 1467916015 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTIN SURGICAL ASSISTANTS LLC | ||||||||
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| OtherOrganizationName: | WESTIN SURGICAL ASSISTANTS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 992 S. 4TH AVE | ||||||||
| Address2: | SUITE 100 #451 | ||||||||
| City: | BRIGHTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806016803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035641781 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 PRAIRIE CENTER PKWY | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806014006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034981600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2019 | ||||||||
| LastUpdateDate: | 01/31/2019 | ||||||||
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| AuthorizedOfficialLastName: | ONTIVEROS | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | TED | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER / SURGICAL ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 3035641781 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CST, SA-C | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251J00000X | Y | Agencies | Nursing Care |
No ID Information.