Healthcare Provider Details

I. General information

NPI: 1790980027
Provider Name (Legal Business Name): COLORADO WOMEN'S HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S POTOMAC ST STE 135
AURORA CO
80012-5442
US

IV. Provider business mailing address

1550 S POTOMAC ST STE 135
AURORA CO
80012-5442
US

V. Phone/Fax

Practice location:
  • Phone: 303-745-8888
  • Fax: 303-369-1062
Mailing address:
  • Phone: 303-745-8888
  • Fax: 303-369-1062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number37990
License Number StateCO

VIII. Authorized Official

Name: DR. GRACE Y CHENG
Title or Position: OWNER
Credential: MD
Phone: 303-745-8888