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NPI Code Detail

MEDICARE: DR. LORETTA SULLIVAN-CHANG MD

MEDICARE:  DR. LORETTA  SULLIVAN-CHANG  MD
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
1207R00000XInternal Medicine PhysicianA100131CA
2207R00000XInternal Medicine Physician49624CO

General Provider Information

NPI Number : 1972780062
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORETTA SULLIVAN-CHANG MD
Provider Business Mailing Address
First Line : 4950 S YOSEMITE ST # F2-365
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-1349
Country : US
Telephone Number : 650-847-7287
Fax Number :
Provider Business Practice Location Address
First Line : 4950 S YOSEMITE ST # F2-365
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111
Country : US
Telephone Number : 650-847-7287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2008
Last Update Date : 04/28/2025

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Directions to “ DR. LORETTA SULLIVAN-CHANG MD” Practice Location

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