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General NPI Number Information
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NPI Number | 1659656783
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Entity Type | Individual
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Provider Name | DAN GUBERUD RPH
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Gender | Male
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 12680 W 64TH AVE
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City | ARVADA
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State | CO
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Zip | 80004-3806
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Country | US
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Telephone | 303-423-6886
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Fax | 303-423-0573
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Provider Business Mailing Address
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Address Line | 12680 W 64TH AVE
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City | ARVADA
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State | CO
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Zip | 80004-3806
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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 |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11799
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License Number State | CO
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