Provider Demographics
NPI:1518287549
Name:MILE HIGH ALLERGY ASTHMA & SINUS CENTER, LLC
Entity Type:Organization
Organization Name:MILE HIGH ALLERGY ASTHMA & SINUS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGADISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGGAVARAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-238-0471
Mailing Address - Street 1:7700 W VIRGINIA AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3144
Mailing Address - Country:US
Mailing Address - Phone:303-238-0471
Mailing Address - Fax:303-238-6711
Practice Address - Street 1:7700 W VIRGINIA AVE
Practice Address - Street 2:UNIT B
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3144
Practice Address - Country:US
Practice Address - Phone:303-238-0471
Practice Address - Fax:303-238-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40997207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty