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General NPI Number Information
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NPI Number | 1982928867
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Entity Type | Organization
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Legal Business Name | MY FAMILY DOCTOR PLLC
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Dates
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Enumeration Date | 03/21/2010
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 1225 CIMARRON DR UNIT 102
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City | LAFAYETTE
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State | CO
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Zip | 80026-3812
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Country | US
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Telephone | 303-444-7150
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 CIMARRON DRIVE, SUITE 102
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City | LAFAYETTE
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State | CO
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Zip | 80026
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Country | US
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Telephone | 303-444-7150
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. LILA SHOSHANA ROSENTHAL
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Credential | M.D.
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Telephone | 303-928-0505
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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 |
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License Number State |
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