Healthcare Provider Details

I. General information

NPI: 1538184775
Provider Name (Legal Business Name): CARDIOVASCULAR ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 W CONEJOS PL SUITE #100
DENVER CO
80204-1377
US

IV. Provider business mailing address

4101 W CONEJOS PL SUITE #100
DENVER CO
80204-1377
US

V. Phone/Fax

Practice location:
  • Phone: 303-595-2600
  • Fax: 303-595-2626
Mailing address:
  • Phone: 303-595-2600
  • Fax: 303-595-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateCO

VIII. Authorized Official

Name: MR. JOHN J. WEISS
Title or Position: OFFICE ADMINISTRATOR
Credential: C.E.O.
Phone: 303-595-2600