Provider Demographics
NPI:1104167329
Name:DIABETES AND ENDOCRINOLOGY OF DENVER INC
Entity type:Organization
Organization Name:DIABETES AND ENDOCRINOLOGY OF DENVER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:JONATHON
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-985-1199
Mailing Address - Street 1:7200 S ALTON WAY STE A120
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2234
Mailing Address - Country:US
Mailing Address - Phone:720-282-2288
Mailing Address - Fax:
Practice Address - Street 1:7200 S ALTON WAY STE A120
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2234
Practice Address - Country:US
Practice Address - Phone:720-282-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47565207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG76877Medicare UPIN