Healthcare Provider Details

I. General information

NPI: 1699797787
Provider Name (Legal Business Name): DENVER VA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

1055 CLERMONT STREET
DENVER CO
80220
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-2869
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number31233
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number31233
License Number StateCO

VIII. Authorized Official

Name: EDWARD CHAN
Title or Position: STAFF PHYSICIAN
Credential: MD
Phone: 303-393-2869