Healthcare Provider Details

I. General information

NPI: 1275765281
Provider Name (Legal Business Name): LUKE YIP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST MC 0180
DENVER CO
80204-4507
US

IV. Provider business mailing address

777 BANNOCK ST MC 0180
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 303-739-1240
  • Fax:
Mailing address:
  • Phone: 303-739-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License Number34251
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: