=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578722708
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EDWARD B ARENSON PROF L L C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2008
-----------------------------------------------------
Last Update Date | 05/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 799 E HAMPDEN AVE SUITE 500
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80113-2700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-788-8675
-----------------------------------------------------
Fax | 303-761-8031
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 799 E HAMPDEN AVE SUITE 500
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80113-2700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-788-8675
-----------------------------------------------------
Fax | 303-761-8031
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | EDWARD B ARENSON
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 303-788-8675
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 18299
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------