MEDICARE: JOE OZAKI M.D.

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	174400000X	Specialist	TD061026	ME
2	174400000X	Specialist	16535	CO

General Provider Information

NPI Number	:	1932142023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE OZAKI M.D.

Provider Business Mailing Address
First Line	:	2302 S JUNIPER WAY
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-6455
Country	:	US
Telephone Number	:	720-280-4916
Fax Number	:	720-389-8014

Provider Business Practice Location Address
First Line	:	2302 S JUNIPER WAY
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-6455
Country	:	US
Telephone Number	:	720-280-4916
Fax Number	:	720-389-8014

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	12/29/2010

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Directions to “ JOE OZAKI M.D.” Practice Location

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