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General NPI Number Information
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NPI Number | 1033889431
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Entity Type | Organization
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Legal Business Name | PRO HEALTH ONE INC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 6060 E ILIFF AVE
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City | DENVER
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State | CO
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Zip | 80222-5721
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Country | US
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Telephone | 866-782-8393
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Fax |
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Provider Business Mailing Address
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Address Line | 8181 E TUFTS AVE STE 560
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City | DENVER
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State | CO
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Zip | 80237-2559
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | PRADEEP RAI
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Credential | MD
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Telephone | 303-209-5115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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