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General NPI Number Information
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NPI Number | 1285774562
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Entity Type | Organization
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Legal Business Name | BELMAT MEDICAL AND ACCUPUNCTURE CENTER
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 550 S WADSWORTH BLVD SUITE 402
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City | LAKEWOOD
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State | CO
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Zip | 80226-3111
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Country | US
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Telephone | 303-936-0377
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Fax | 303-936-0387
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Provider Business Mailing Address
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Address Line | 550 S WADSWORTH BLVD SUITE 402
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City | LAKEWOOD
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State | CO
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Zip | 80226-3111
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Country | US
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Telephone | 303-936-0377
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Fax | 303-936-0387
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOAN THU PHAM
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Credential | M.D.
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Telephone | 303-936-0377
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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 | 40215
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License Number State | CO
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