Organization · Type 2 NPI

Colorado Retina Associates, PLLC

Medical Specialty Clinic/Center · Denver, CO

NPI number 1508435967 Active

Practice location

3401 Quebec St # 105
Denver, CO 80207-2322

Call (303) 261-1600 Map

Fax (303) 261-1601

Mailing address

PO Box 17949
Denver, CO 80217-0949

Specialties and licenses

Taxonomy	Code	License
Retina Specialist (Ophthalmology) Physician	207WX0107X	None listed
Medical Specialty Clinic/Center Primary	261QM2500X	None listed

Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

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NPI record

NPI: 1508435967
Entity type: Organization (Type 2)
Issued: Jun 21, 2021
Last updated: Nov 16, 2021
Status: Active
Subpart: Yes of Colorado Retina Associates, PLLC

Other names

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Colorado Retina Associates, PC · former legal business name

Authorized official

Kylie Wakasugi
Credentialing Specialist
(303) 261-1600

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1508435967

Colorado Retina Associates, PLLC's National Provider Identifier is 1508435967, issued on Jun 21, 2021. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Denver, CO. The record was last updated on Nov 16, 2021.