Healthcare Provider Details

I. General information

NPI: 1164483657
Provider Name (Legal Business Name): PHILIP ZIPORIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2006
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 W CONEJOS PL 300
DENVER CO
80204
US

IV. Provider business mailing address

PO BOX 151029
LAKEWOOD CO
80215-9029
US

V. Phone/Fax

Practice location:
  • Phone: 303-629-3566
  • Fax: 303-629-3727
Mailing address:
  • Phone: 303-988-0720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberCO19515
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: