Healthcare Provider Details

I. General information

NPI: 1487298485
Provider Name (Legal Business Name): ZEPOL ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9725 E HAMPDEN AVE STE 308
DENVER CO
80231-4919
US

IV. Provider business mailing address

9725 E HAMPDEN AVE STE 308
DENVER CO
80231-4919
US

V. Phone/Fax

Practice location:
  • Phone: 303-339-0420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW LOPEZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 516-287-3622