Healthcare Provider Details

I. General information

NPI: 1407437312
Provider Name (Legal Business Name): JOSEPH NATHANSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 ROSLYN ST UNIT 100
DENVER CO
80238-3326
US

IV. Provider business mailing address

1860 S NEWPORT ST
DENVER CO
80224-2250
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-7900
  • Fax: 303-399-7999
Mailing address:
  • Phone: 720-951-2094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0075710
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: