Healthcare Provider Details

I. General information

NPI: 1134268360
Provider Name (Legal Business Name): DAVID MUNOZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W CONEJOS PL SUITE 134
DENVER CO
80204-1333
US

IV. Provider business mailing address

1921 SHERIDAN BLVD UNIT C
EDGEWATER CO
80214-1314
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-8880
  • Fax: 720-321-8881
Mailing address:
  • Phone: 720-321-8880
  • Fax: 720-321-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number33332
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: