Provider Demographics
NPI:1306339163
Name:COLORADO URGENT CARE PHYSICIANS, PC
Entity type:Organization
Organization Name:COLORADO URGENT CARE PHYSICIANS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRIT
Authorized Official - Middle Name:W
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-761-1699
Mailing Address - Street 1:901 W HAMPDEN AVE UNIT 103
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-7330
Mailing Address - Country:US
Mailing Address - Phone:303-761-1699
Mailing Address - Fax:303-761-1475
Practice Address - Street 1:5102 SOUTH BROADWAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113
Practice Address - Country:US
Practice Address - Phone:303-761-1699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO URGENT CARE PHYSICIANS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-07
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31180566Medicaid