Healthcare Provider Details

I. General information

NPI: 1952818411
Provider Name (Legal Business Name): RETINA SPECIALISTS OF COLORADO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 S POTOMAC ST STE 175
AURORA CO
80012-4508
US

IV. Provider business mailing address

1444 S POTOMAC ST STE 175
AURORA CO
80012-4508
US

V. Phone/Fax

Practice location:
  • Phone: 314-363-4057
  • Fax:
Mailing address:
  • Phone: 720-443-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberDR.0059415
License Number StateCO

VIII. Authorized Official

Name: DR. ROSS CHOD
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 720-443-2425