Provider Demographics
NPI:1427224948
Name:SAPPHIRE PEDIATRICS
Entity Type:Organization
Organization Name:SAPPHIRE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:LARABEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-941-1778
Mailing Address - Street 1:4500 E. 9TH AVE #740
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:720-941-1778
Mailing Address - Fax:720-941-1783
Practice Address - Street 1:4500 E. 9TH AVE #740
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:720-941-1778
Practice Address - Fax:720-941-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42585208000000X
CO42491208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO70935564Medicaid