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General NPI Number Information
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NPI Number | 1992689178
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Entity Type | Organization
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Legal Business Name | REDWOOD MEDICAL LLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 3400 E BAYAUD AVE STE 333
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City | DENVER
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State | CO
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Zip | 80209-2929
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Country | US
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Telephone | 720-485-3178
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 S PERRY ST STE 104B
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City | CASTLE ROCK
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State | CO
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Zip | 80104-1950
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Country | US
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Telephone | 720-485-3178
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Fax | 720-414-0006
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRENT HERRON
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Credential |
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Telephone | 303-249-0908
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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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