Provider Demographics
NPI:1033245915
Name:DANESHBOD-SKIBBA, GHODSI (MD)
Entity Type:Individual
Prefix:DR
First Name:GHODSI
Middle Name:
Last Name:DANESHBOD-SKIBBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 W.80TH AVE.
Mailing Address - Street 2:SUITE 24
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005
Mailing Address - Country:US
Mailing Address - Phone:303-422-6686
Mailing Address - Fax:303-456-6814
Practice Address - Street 1:9950 W.80TH AVE.
Practice Address - Street 2:SUITE 24
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005
Practice Address - Country:US
Practice Address - Phone:303-422-6686
Practice Address - Fax:303-456-6814
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23903174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01239037Medicaid