Healthcare Provider Details

I. General information

NPI: 1053678169
Provider Name (Legal Business Name): AVASH KALRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 AURORA CT
AURORA CO
80045-2541
US

IV. Provider business mailing address

1721 E 19TH AVE STE 520
DENVER CO
80218-1243
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone: 720-754-8134
  • Fax: 303-869-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0055257
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number0055257
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: