Integrated Dermatology Of Boulder Creek, Llc
LBN: Integrated Dermatology Of Boulder Creek, Llc
Integrated Dermatology Of Boulder Creek, Llc is an health care organization with primary practice located at 400 S Mccaslin Blvd Ste 100 , Superior CO 80027-9701. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Integrated Dermatology Of Boulder Creek, Llc can be contacted via phone (303) 666-5261, or through Fuentes, David via phone (561) 314-2000.
Contact Information
Primary practice address
400 S Mccaslin Blvd Ste 100
Superior CO 80027-9701
Phone: (303) 666-5261
Fax: (303) 604-6062
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | ||
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1568033066 |
|---|---|
| LBN Legal business name | Integrated Dermatology Of Boulder Creek, Llc |
| DBA Doing business as | |
| Authorized official | Fuentes, David |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 6th, 2021 |
| Last updated | Jul 6th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568033066 | NPPES |
| Colorado | MEDICAID | 9000168857 |
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