| NPI | 1497389399 |
|---|---|
| Former Legal Business Name | COLORADO RETINA ASSOCIATES, PC |
| Entity Type | Organization |
| Authorized Contact | KYLIE WAKASUGI Credentialing Specialist 303-261-1600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist |
| 207WX0108X Ophthalmology Uveitis and Ocular Inflammatory Disease | |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2022-06-14 |