Healthcare Provider Details

I. General information

NPI: 1417079070
Provider Name (Legal Business Name): DENVER FAMILY MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MARION STREET
DENVER CO
80218-1121
US

IV. Provider business mailing address

1700 MARION STREET
DENVER CO
80218-1121
US

V. Phone/Fax

Practice location:
  • Phone: 303-830-6666
  • Fax: 303-830-7099
Mailing address:
  • Phone: 303-830-6666
  • Fax: 303-830-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANA PAYAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 303-830-6666