Healthcare Provider Details

I. General information

NPI: 1801282272
Provider Name (Legal Business Name): NATHAN RUBALCAVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2015
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST STE 370
DENVER CO
80205-5545
US

IV. Provider business mailing address

2055 N HIGH ST STE 370
DENVER CO
80205-5545
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberDR.0075928
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDR.0075928
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberDR.0075928
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: