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General NPI Number Information
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NPI Number | 1386164663
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Entity Type | Individual
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Provider Name | ALYSSA AYA SELF MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 1400 JACKSON ST
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City | DENVER
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State | CO
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Zip | 80206-2762
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Country | US
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Telephone | 303-398-1197
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 JACKSON ST # J200A
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City | DENVER
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State | CO
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Zip | 80206-2762
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Country | US
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Telephone | 303-398-1197
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2017020317
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | DR.0072562
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | DR.0072562
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License Number State | CO
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