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General NPI Number Information
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NPI Number | 1124450366
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Entity Type | Organization
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Legal Business Name | LAKEWOOD MEDICAL CENTER CORPORATION
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 1700 WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80214-5256
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Country | US
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Telephone | 303-238-1488
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Fax | 303-238-1459
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Provider Business Mailing Address
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Address Line | 1700 WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80214-5256
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Country | US
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Telephone | 303-238-1488
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Fax | 303-238-1459
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAI PHONG BUI
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Credential | M.D.
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Telephone | 303-238-1488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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