Healthcare Provider Details

I. General information

NPI: 1497116560
Provider Name (Legal Business Name): DARRELL WEST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 W 14TH AVE
DENVER CO
80204-2203
US

IV. Provider business mailing address

3231 NIAGARA ST
DENVER CO
80207-2211
US

V. Phone/Fax

Practice location:
  • Phone: 303-300-6266
  • Fax:
Mailing address:
  • Phone: 720-403-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: