Healthcare Provider Details

I. General information

NPI: 1063887842
Provider Name (Legal Business Name): YAEL FARAH DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2015
Last Update Date: 12/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 GALAPAGO ST
DENVER CO
80204-3942
US

IV. Provider business mailing address

1041 GALAPAGO ST
DENVER CO
80204-3942
US

V. Phone/Fax

Practice location:
  • Phone: 303-595-3561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberVET.0010428
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: