Healthcare Provider Details

I. General information

NPI: 1023245131
Provider Name (Legal Business Name): WESTCOAST HEALTH MANAGEMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHAMBERS RD STE 200
AURORA CO
80011-7130
US

IV. Provider business mailing address

601 CHAMBERS RD STE 200
AURORA CO
80011-7130
US

V. Phone/Fax

Practice location:
  • Phone: 303-577-9780
  • Fax: 303-577-9785
Mailing address:
  • Phone: 303-577-9780
  • Fax: 303-577-9785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MAXIM GUZMAN
Title or Position: PRESIDENT
Credential:
Phone: 303-577-9780