Healthcare Provider Details

I. General information

NPI: 1205867306
Provider Name (Legal Business Name): BRUCE B CAZDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 W 120TH AVE SUITE 100
WESTMINSTER CO
80020-3314
US

IV. Provider business mailing address

8300 W 38TH AVE 2ND FLOOR EPN CRED
WHEAT RIDGE CO
80033-6005
US

V. Phone/Fax

Practice location:
  • Phone: 303-469-1988
  • Fax: 303-469-3856
Mailing address:
  • Phone: 303-403-3880
  • Fax: 303-425-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33324
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: