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General NPI Number Information
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NPI Number | 1316300882
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Entity Type | Organization
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Legal Business Name | GOLD COAST PHYSICIAN READERS INC
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 8547 E ARAPAHOE RD SUITE J 555
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80112-1436
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Country | US
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Telephone | 877-446-4945
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Fax |
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Provider Business Mailing Address
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Address Line | 8547 E ARAPAHOE RD SUITE J 555
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80112-1436
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Country | US
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Telephone | 877-446-4945
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS DOSUMU-JOHNSON
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Credential | M.D.
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Telephone | 877-446-4945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | A34329
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License Number State | CA
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