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General NPI Number Information
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NPI Number | 1720377294
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Entity Type | Individual
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Provider Name | ELISE AILEEN HIZA MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 875 W 136TH AVE
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City | BROOMFIELD
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State | CO
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Zip | 80023-9303
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Country | US
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Telephone | 303-544-3820
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110429
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City | AURORA
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State | CO
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Zip | 80042-0429
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | DR.0065389
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License Number State | CO
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