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General NPI Number Information
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NPI Number | 1457465767
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE COLORADO
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2525 13TH ST
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City | BOULDER
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State | CO
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Zip | 80304-4104
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Country | US
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Telephone | 303-440-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 13TH ST
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City | BOULDER
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State | CO
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Zip | 80304-4104
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP HEALTH PLAN ADMINISTRATION
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Name | ANNE E MCDOW
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Credential |
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Telephone | 303-344-7655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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