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General NPI Number Information
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NPI Number | 1669493805
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Entity Type | Individual
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Provider Name | GHASSAN MOHAMED GHUNEIM
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Gender | Male
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 5920 MCINTYRE ST
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City | GOLDEN
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State | CO
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Zip | 80403-7445
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Country | US
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Telephone | 720-434-4876
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Fax | 303-225-4246
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Provider Business Mailing Address
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Address Line | 5920 MCINTYRE ST
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City | GOLDEN
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State | CO
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Zip | 80403-7445
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Country | US
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Telephone | 720-434-4876
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Fax | 303-225-4246
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0051042
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2000-193
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | DR.0051042
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License Number State | CO
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