Provider Demographics
NPI:1598132615
Name:MCCOMBS, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MCCOMBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6554 S PARKER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6554 S PARKER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-4737
Practice Address - Country:US
Practice Address - Phone:720-644-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0013538174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist