Healthcare Provider Details

I. General information

NPI: 1891445003
Provider Name (Legal Business Name): RONNY YIP DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12700 E 19TH AVE
AURORA CO
80045-2507
US

IV. Provider business mailing address

12700 E 19TH AVE MAIL STOP B182
AURORA CO
80045-2507
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-4127
  • Fax:
Mailing address:
  • Phone: 303-724-4127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDR.0072279
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: