Provider Demographics
NPI:1093756561
Name:PRECISION HEALTH INC
Entity Type:Organization
Organization Name:PRECISION HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MALMGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PA
Authorized Official - Phone:303-450-9970
Mailing Address - Street 1:680 W 121ST AVE
Mailing Address - Street 2:SUITE100
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-4223
Mailing Address - Country:US
Mailing Address - Phone:303-450-9970
Mailing Address - Fax:303-254-9590
Practice Address - Street 1:680 W 121ST AVE
Practice Address - Street 2:SUITE100
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-4223
Practice Address - Country:US
Practice Address - Phone:303-450-9970
Practice Address - Fax:303-254-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3160111N00000X
CO40901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO805468Medicare PIN