Provider Demographics
NPI:1043282304
Name:KHALIGHI, PAYAM (DO)
Entity Type:Individual
Prefix:
First Name:PAYAM
Middle Name:
Last Name:KHALIGHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5817
Mailing Address - Country:US
Mailing Address - Phone:303-715-7184
Mailing Address - Fax:720-874-5886
Practice Address - Street 1:2525 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5817
Practice Address - Country:US
Practice Address - Phone:303-715-7184
Practice Address - Fax:720-874-5886
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36837207R00000X
CODR.0036837208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76677249Medicaid
COC318818Medicare PIN
CO76677249Medicaid