Healthcare Provider Details
I. General information
NPI: 1427507870
Provider Name (Legal Business Name): U.S. HEALTHWORKS PROVIDER NETWORK OF COLORADO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2016
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8200 E BELLEVIEW AVE #428 C
GREENWOOD VILLAGE CO
80111-2803
US
IV. Provider business mailing address
25124 SPRINGFIELD CT SUITE 200
VALENCIA CA
91355-1085
US
V. Phone/Fax
- Phone: 303-741-1166
- Fax: 303-741-2221
- Phone: 661-678-2600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
T
MALLAS
Title or Position: PRESIDENT
Credential:
Phone: 661-678-2600