MEDICARE: DR. TALISA FOREST MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0107X	Retina Specialist (Ophthalmology) Physician	DR.0063712	CO

General Provider Information

NPI Number	:	1154783447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TALISA FOREST MD

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 AURORA CT STE F731
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2592
Country	:	US
Telephone Number	:	720-848-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2016
Last Update Date	:	10/04/2022

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Directions to “ DR. TALISA FOREST MD” Practice Location

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