Healthcare Provider Details

I. General information

NPI: 1457359820
Provider Name (Legal Business Name): COLORADO ANESTHESIA CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SHERMAN STREET SUITE 510
DENVER CO
80203-4405
US

IV. Provider business mailing address

455 SHERMAN ST STE 510
DENVER CO
80203-4400
US

V. Phone/Fax

Practice location:
  • Phone: 303-377-6825
  • Fax: 303-780-0787
Mailing address:
  • Phone: 303-377-6825
  • Fax: 303-780-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRAD BOOS
Title or Position: CFO
Credential:
Phone: 303-377-6825