Healthcare Provider Details

I. General information

NPI: 1003866880
Provider Name (Legal Business Name): KIT K BREKHUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 W YALE AVE STE 100
DENVER CO
80227-3465
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 303-935-4689
  • Fax: 303-935-3829
Mailing address:
  • Phone: 719-400-7470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCDRH.0030901
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: