Provider Demographics
NPI:1528003662
Name:DENVER URGENT CARE PROFESSIONAL LLC
Entity Type:Organization
Organization Name:DENVER URGENT CARE PROFESSIONAL LLC
Other - Org Name:ZIPCLINIC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-455-6345
Mailing Address - Street 1:1 BROADWAY
Mailing Address - Street 2:BLDG A, SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3959
Mailing Address - Country:US
Mailing Address - Phone:303-455-6345
Mailing Address - Fax:303-455-6343
Practice Address - Street 1:1 BROADWAY
Practice Address - Street 2:BLDG A, SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3959
Practice Address - Country:US
Practice Address - Phone:303-455-6345
Practice Address - Fax:303-455-6343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X
CO261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97406864Medicaid
CO5769470001Medicare NSC
CO5769470001Medicare NSC