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General NPI Number Information
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NPI Number | 1699951004
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Entity Type | Individual
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Provider Name | JOHN JOSEPH BARDASH O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 6460 E YALE AVE STE. A20
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City | DENVER
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State | CO
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Zip | 80222-7156
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Country | US
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Telephone | 720-316-7739
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Fax | 720-259-9360
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Provider Business Mailing Address
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Address Line | 6460 E YALE AVE STE. A20
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City | DENVER
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State | CO
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Zip | 80222-7156
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Country | US
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Telephone | 720-316-7739
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Fax | 720-259-9360
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2635
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License Number State | CO
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