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General NPI Number Information
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NPI Number | 1003078064
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Entity Type | Organization
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Legal Business Name | COLORADO ENDOCRINOLOGY, THYROID AND DIABETES CONSULTANTS, P.C.
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 10099 RIDGEGATE PKWY SUITE 480
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City | LONE TREE
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State | CO
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Zip | 80124-5531
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Country | US
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Telephone | 303-790-2400
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Fax | 303-790-2408
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Provider Business Mailing Address
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Address Line | 10099 RIDGEGATE PKWY SUITE 480
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City | LONE TREE
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State | CO
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Zip | 80124-5531
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Country | US
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Telephone | 303-790-2400
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Fax | 303-790-2408
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Authorized Official
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Title or Position | CEO
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Name | DR. REBECCA JOHN
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Credential | MD
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Telephone | 303-790-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 46494
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License Number State | CO
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