Healthcare Provider Details

I. General information

NPI: 1043969603
Provider Name (Legal Business Name): ALLAN BARRAZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 N OGDEN ST STE 340
DENVER CO
80218-3669
US

IV. Provider business mailing address

12631 E 17TH AVE RM 4405
AURORA CO
80045-2527
US

V. Phone/Fax

Practice location:
  • Phone: 303-318-3830
  • Fax:
Mailing address:
  • Phone: 303-724-2038
  • Fax: 303-724-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0072018
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: