Healthcare Provider Details

I. General information

NPI: 1831326495
Provider Name (Legal Business Name): VIRAL KOTHARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 E WOODMEN RD STE 330
COLORADO SPRINGS CO
80923-2624
US

IV. Provider business mailing address

9235 N UNION BLVD STE 150-334
COLORADO SPRINGS CO
80920-7831
US

V. Phone/Fax

Practice location:
  • Phone: 800-506-8933
  • Fax:
Mailing address:
  • Phone: 719-638-1122
  • Fax: 719-638-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1.051574
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number47325
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP4665
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27301
License Number StateOK
# 5
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberDR.0059150
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: