Healthcare Provider Details

I. General information

NPI: 1255209177
Provider Name (Legal Business Name): MR. ASBI MIZER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4114 LISBON ST
DENVER CO
80249-8205
US

IV. Provider business mailing address

4114 LISBON ST
DENVER CO
80249-8205
US

V. Phone/Fax

Practice location:
  • Phone: 720-468-8682
  • Fax:
Mailing address:
  • Phone: 720-468-8682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: