Provider Demographics
NPI:1316318645
Name:DIAMONTOPOULOS, AJ
Entity type:Individual
Prefix:MR
First Name:AJ
Middle Name:
Last Name:DIAMONTOPOULOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SOUTH BROADWAY SUITE 700
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:303-455-1000
Mailing Address - Fax:303-480-6700
Practice Address - Street 1:1290 SOUTH BROADWAY SUITE 700
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203
Practice Address - Country:US
Practice Address - Phone:303-455-1000
Practice Address - Fax:303-480-6700
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker