Healthcare Provider Details

I. General information

NPI: 1083273049
Provider Name (Legal Business Name): MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 E ILIFF AVE
DENVER CO
80222-6025
US

IV. Provider business mailing address

1780 S BELLAIRE ST STE 402
DENVER CO
80222-4323
US

V. Phone/Fax

Practice location:
  • Phone: 303-946-3322
  • Fax:
Mailing address:
  • Phone: 303-946-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAMIN VATAN
Title or Position: CEO
Credential:
Phone: 303-946-3322