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NPI Code Detail

MEDICARE: DR. RANDOLPH F BACA D.C.

MEDICARE: DR. RANDOLPH F BACA D.C.
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
1111NR0200XRadiology Chiropractor1473CO

General Provider Information

NPI Number : 1558660555
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDOLPH F BACA D.C.
Provider Business Mailing Address
First Line : 8725 WADSWORTH BLVD STE A
Second Line :
City : ARVADA
State : CO
Zip : 80003-0922
Country : US
Telephone Number : 303-425-7298
Fax Number : 303-940-8330
Provider Business Practice Location Address
First Line : 8725 WADSWORTH BLVD STE A
Second Line :
City : ARVADA
State : CO
Zip : 80003-0922
Country : US
Telephone Number : 303-425-7298
Fax Number : 303-940-8330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 03/16/2011

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Directions to “ DR. RANDOLPH F BACA D.C.” Practice Location

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