Healthcare Provider Details

I. General information

NPI: 1427224948
Provider Name (Legal Business Name): SAPPHIRE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E. 9TH AVE #740
DENVER CO
80220
US

IV. Provider business mailing address

4500 E. 9TH AVE #740
DENVER CO
80220
US

V. Phone/Fax

Practice location:
  • Phone: 720-941-1778
  • Fax: 720-941-1783
Mailing address:
  • Phone: 720-941-1778
  • Fax: 720-941-1783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42491
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42585
License Number StateCO

VIII. Authorized Official

Name: DR. ROBIN MARCUS LARABEE
Title or Position: PRIMARY PROVIDER
Credential: M.D.
Phone: 720-941-1778