Healthcare Provider Details
I. General information
NPI: 1053685149
Provider Name (Legal Business Name): KAISER FOUNDATION HEALTH PLAN OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2012
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2045 N FRANKLIN ST
DENVER CO
80205-5437
US
IV. Provider business mailing address
10350 E DAKOTA AVE
DENVER CO
80247-1314
US
V. Phone/Fax
- Phone: 303-338-4545
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
S
RAMSEIER
Title or Position: REGIONAL PRESIDENT
Credential:
Phone: 303-344-7256