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General NPI Number Information
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NPI Number | 1235289554
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Entity Type | Organization
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Legal Business Name | COLORADO CANCER CARE LLC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 3601 S CLARKSON ST STE 520
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3949
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Country | US
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Telephone | 303-346-7777
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Fax | 303-346-7778
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Provider Business Mailing Address
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Address Line | 3601 S CLARKSON ST STE 520
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3949
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Country | US
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Telephone | 303-346-7777
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Fax | 303-346-7778
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RAUL ALVAREZ
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Credential | M.D.
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Telephone | 303-346-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 23836
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License Number State | CO
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