Healthcare Provider Details

I. General information

NPI: 1770791055
Provider Name (Legal Business Name): JAREN M RILEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 01/26/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST #130
DENVER CO
80205-5503
US

IV. Provider business mailing address

4900 S MONACO ST #210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-2663
  • Fax: 303-861-4741
Mailing address:
  • Phone: 303-861-2663
  • Fax: 303-861-4741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR-7402
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number48800
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: