Provider Demographics
NPI:1962580001
Name:ZELLER, CLIFFORD LORIN (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:LORIN
Last Name:ZELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 S ULSTER ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2804
Mailing Address - Country:US
Mailing Address - Phone:720-381-0015
Mailing Address - Fax:720-381-0149
Practice Address - Street 1:5031 S ULSTER ST
Practice Address - Street 2:SUITE 350
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2804
Practice Address - Country:US
Practice Address - Phone:720-381-0015
Practice Address - Fax:720-381-0149
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR184482084P0800X
AZ451162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16437373Medicaid
AZ647945Medicaid
AZZ148625Medicare PIN
COCO400029Medicare PIN
CO16437373Medicaid