Healthcare Provider Details

I. General information

NPI: 1982077020
Provider Name (Legal Business Name): HUGH YLARRAZ CONTRACTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 PERRY ST
DENVER CO
80212-2605
US

IV. Provider business mailing address

5121 PERRY ST
DENVER CO
80212-2605
US

V. Phone/Fax

Practice location:
  • Phone: 303-921-2138
  • Fax:
Mailing address:
  • Phone: 303-921-2138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberAEC1409
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberGCC5123018
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: