Provider Demographics
NPI:1467916015
Name:WESTIN SURGICAL ASSISTANTS LLC
Entity Type:Organization
Organization Name:WESTIN SURGICAL ASSISTANTS LLC
Other - Org Name:WESTIN SURGICAL ASSISTANTS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER / SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:TED
Authorized Official - Last Name:ONTIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:CST, SA-C
Authorized Official - Phone:303-564-1781
Mailing Address - Street 1:992 S. 4TH AVE
Mailing Address - Street 2:SUITE 100 #451
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-6803
Mailing Address - Country:US
Mailing Address - Phone:303-564-1781
Mailing Address - Fax:
Practice Address - Street 1:1600 PRAIRIE CENTER PKWY
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4006
Practice Address - Country:US
Practice Address - Phone:303-498-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care