Provider Demographics
NPI:1033474879
Name:SEDA RADIOLOGY PC
Entity Type:Organization
Organization Name:SEDA RADIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-565-1602
Mailing Address - Street 1:3795 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-4202
Mailing Address - Country:US
Mailing Address - Phone:303-565-1602
Mailing Address - Fax:
Practice Address - Street 1:3795 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-4202
Practice Address - Country:US
Practice Address - Phone:303-565-1602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO299642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty