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NPI Code Detail

MEDICARE: DR. JOSEPH G ABDALLAH M.D.

MEDICARE: DR. JOSEPH G ABDALLAH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianDR.0050531CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3028698OTHERCOKAISER COMMERCIAL NUMBER

General Provider Information

NPI Number : 1306843602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH G ABDALLAH M.D.
Provider Business Mailing Address
First Line : 8410 DECATUR ST STE 100
Second Line :
City : WESTMINSTER
State : CO
Zip : 80031-3811
Country : US
Telephone Number : 303-430-7000
Fax Number : 303-430-1506
Provider Business Practice Location Address
First Line : 8410 DECATUR ST STE 100
Second Line :
City : WESTMINSTER
State : CO
Zip : 80031-3811
Country : US
Telephone Number : 303-430-7000
Fax Number : 303-430-1506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 05/14/2021

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