Healthcare Provider Details

I. General information

NPI: 1639702467
Provider Name (Legal Business Name): FLATIRON ALLERGY & ASTHMA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 FOLSOM ST STE 105
BOULDER CO
80302-5712
US

IV. Provider business mailing address

90 HEALTH PARK DR STE 170
LOUISVILLE CO
80027-8702
US

V. Phone/Fax

Practice location:
  • Phone: 303-862-3303
  • Fax: 303-862-3308
Mailing address:
  • Phone: 303-862-3303
  • Fax: 303-862-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHOBAN ARUN DAVE
Title or Position: OWNER
Credential: MD
Phone: 303-862-3303