Healthcare Provider Details

I. General information

NPI: 1457600231
Provider Name (Legal Business Name): DENVER PAIN AND SPINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 09/26/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14828 W 6TH AVE STE 16-B
GOLDEN CO
80401-5000
US

IV. Provider business mailing address

14828 W 6TH AVE STE 16-B
GOLDEN CO
80401-5000
US

V. Phone/Fax

Practice location:
  • Phone: 720-541-6800
  • Fax: 720-541-6801
Mailing address:
  • Phone: 720-541-6800
  • Fax: 720-541-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANGELA S ACOSTA
Title or Position: GENERAL MANAGER
Credential: MA
Phone: 720-541-6800