Healthcare Provider Details

I. General information

NPI: 1598604894
Provider Name (Legal Business Name): FREEDA PINKHASOV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11659 E MONTANA PL
AURORA CO
80012-5218
US

IV. Provider business mailing address

11659 E MONTANA PL
AURORA CO
80012-5218
US

V. Phone/Fax

Practice location:
  • Phone: 623-980-9865
  • Fax:
Mailing address:
  • Phone: 623-980-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025097909
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: