Provider Demographics
NPI:1891880662
Name:ADRID, ERIC (PA-C)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ADRID
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-1103
Mailing Address - Fax:
Practice Address - Street 1:5920 S ESTES ST STE 250
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8620
Practice Address - Country:US
Practice Address - Phone:303-973-3529
Practice Address - Fax:303-973-3549
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1764363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant