Provider Demographics
NPI:1427060615
Name:DENVER CARDIAC SURGERY PC
Entity type:Organization
Organization Name:DENVER CARDIAC SURGERY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-832-6165
Mailing Address - Street 1:2005 FRANKLIN ST
Mailing Address - Street 2:MIDTOWN 1, SUITE 700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5401
Mailing Address - Country:US
Mailing Address - Phone:303-832-6165
Mailing Address - Fax:303-839-8956
Practice Address - Street 1:2005 FRANKLIN ST
Practice Address - Street 2:MIDTOWN 1, SUITE 700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5401
Practice Address - Country:US
Practice Address - Phone:303-832-6165
Practice Address - Fax:303-839-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04006177Medicaid
CO04006177Medicaid