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General NPI Number Information
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NPI Number | 1093752206
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Entity Type | Individual
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Provider Name | RAFAEL J OLIVARES MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 255 S ROUTT ST STE 300
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City | LAKEWOOD
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State | CO
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Zip | 80228-2354
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Country | US
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Telephone | 720-321-8280
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Fax | 720-321-8281
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Provider Business Mailing Address
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Address Line | 255 S ROUTT ST STE 300
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City | LAKEWOOD
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State | CO
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Zip | 80228-2354
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Country | US
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Telephone | 720-321-8280
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Fax | 720-321-8281
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 40125
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License Number State | CO
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