Provider Demographics
NPI:1093752206
Name:OLIVARES, RAFAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:J
Last Name:OLIVARES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:255 S ROUTT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2354
Mailing Address - Country:US
Mailing Address - Phone:720-321-8280
Mailing Address - Fax:720-321-8281
Practice Address - Street 1:255 S ROUTT ST STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2354
Practice Address - Country:US
Practice Address - Phone:720-321-8280
Practice Address - Fax:720-321-8281
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2025-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO40125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37127527Medicaid
COCOA109125Medicare PIN