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NPI Code Detail

MEDICARE: BANNER HEALTH PHYSICIANS COLORADO LLC

MEDICARE: BANNER HEALTH PHYSICIANS COLORADO LLC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1295096535
Entity Type Code : Organization
Provider Name (Legal Business Name) : BANNER HEALTH PHYSICIANS COLORADO LLC
Provider Business Mailing Address
First Line : 2901 N CENTRAL AVE STE 160
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2702
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1813 CHEYENNE AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80538-4244
Country : US
Telephone Number : 970-203-6801
Fax Number :
Authorized Official
Title or Position : CEO
Name : SHIVA BIRDI
Credential :
Telephone Number : 602-747-4000
Provider Enumeration Date : 06/04/2012
Last Update Date : 04/15/2026

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Directions to “BANNER HEALTH PHYSICIANS COLORADO LLC ” Practice Location

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