| Lakewood Internal Medicine Professional Llc | |
|
1805 Kipling St Lakewood CO 80215-2873 | |
| (303) 231-9700 | |
| Not Available |
| Full Name | Lakewood Internal Medicine Professional Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1805 Kipling St, Lakewood, Colorado |
| Authorized Official Name and Position | David Marc Leon (OWNER) |
| Authorized Official Contact | 3032319700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Internal Medicine Professional Llc 1805 Kipling St Lakewood CO 80215-2873 Ph: (303) 231-9700 | Lakewood Internal Medicine Professional Llc 1805 Kipling St Lakewood CO 80215-2873 Ph: (303) 231-9700 |
| NPI Number | 1457548265 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 09/09/2019 |
| Medicare PECOS PAC ID | 4587630033 |
|---|---|
| Medicare Enrollment ID | O20040907000290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457548265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Colorado) | Primary |
| Provider Name | David M Leon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174605737 PECOS PAC ID: 8022204114 Enrollment ID: I20101201000892 |
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