Healthcare Provider Details

I. General information

NPI: 1891880662
Provider Name (Legal Business Name): ERIC ADRID PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/24/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 S ESTES ST STE 250
LITTLETON CO
80123-8620
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 303-973-3529
  • Fax: 303-973-3549
Mailing address:
  • Phone: 970-624-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1764
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: