| Forum Family Medicine Pc | |
|
14001 E Iliff Ave Ste 109 Aurora CO 80014-1405 | |
| (303) 996-1020 | |
| (303) 751-4514 |
| Full Name | Forum Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 14001 E Iliff Ave, Aurora, Colorado |
| Authorized Official Name and Position | Laurence Richard Tormohlen (MANAGING PARTNER) |
| Authorized Official Contact | 3039961020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forum Family Medicine Pc 14001 E Iliff Ave Ste 109 Aurora CO 80014-1405 Ph: (303) 996-1020 | Forum Family Medicine Pc 14001 E Iliff Ave Ste 109 Aurora CO 80014-1405 Ph: (303) 996-1020 |
| NPI Number | 1114116274 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 10/15/2007 |
| Medicare PECOS PAC ID | 3274423983 |
|---|---|
| Medicare Enrollment ID | O20040317000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114116274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Phillip D Quintana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447246079 PECOS PAC ID: 6103716824 Enrollment ID: I20120424000651 |
| Provider Name | Laurence R Tormohlen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275529802 PECOS PAC ID: 0345130050 Enrollment ID: I20120517000285 |
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