Healthcare Provider Details

I. General information

NPI: 1801576871
Provider Name (Legal Business Name): PROSTATE CANCER INSTITUTE OF COLORADO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 E HAMPDEN AVE STE 400
DENVER CO
80231-4844
US

IV. Provider business mailing address

1445 W CHANDLER BLVD STE A5
CHANDLER AZ
85224-6130
US

V. Phone/Fax

Practice location:
  • Phone: 303-276-4146
  • Fax: 303-276-4147
Mailing address:
  • Phone: 480-360-4009
  • Fax: 480-360-4124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: AJAY BHATNAGAR
Title or Position: OWNER
Credential: MD
Phone: 480-360-4009