Healthcare Provider Details

I. General information

NPI: 1447496377
Provider Name (Legal Business Name): AMBULATORY ANESTHESIA CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2008
Last Update Date: 12/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 DENVER WEST DR SUITE 200
GOLDEN CO
80401-3118
US

IV. Provider business mailing address

PO BOX 668
ARVADA CO
80001-0668
US

V. Phone/Fax

Practice location:
  • Phone: 303-422-9438
  • Fax:
Mailing address:
  • Phone: 303-422-9438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number30336
License Number StateCO

VIII. Authorized Official

Name: MICHAEL URBAN
Title or Position: PRESIDENT
Credential: MD
Phone: 303-422-9438