Provider Demographics
NPI:1568838704
Name:PENROSE-ST. FRANCIS HEALTH CARE FOUNDATION
Entity Type:Organization
Organization Name:PENROSE-ST. FRANCIS HEALTH CARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATHOLOGY RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALAFBEIGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-813-1605
Mailing Address - Street 1:2222 N NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6819
Mailing Address - Country:US
Mailing Address - Phone:719-776-5816
Mailing Address - Fax:
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-776-5816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0004962282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital