1245373794 NPI number — MARK E LOVE P.A.-C.

Table of content: MARK E LOVE P.A.-C. (NPI 1245373794)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245373794 NPI number — MARK E LOVE P.A.-C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOVE
Provider First Name:
MARK
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.-C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245373794
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 E 19TH AVE
Provider Second Line Business Mailing Address:
SUITE 3550
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80218-1216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-832-2955
Provider Business Mailing Address Fax Number:
303-832-2954

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 E 19TH AVE
Provider Second Line Business Practice Location Address:
SUITE 3550
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80218-1216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-832-2955
Provider Business Practice Location Address Fax Number:
303-832-2954
Provider Enumeration Date:
02/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  136 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003402 . This is a "KAISER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com