Provider Demographics
NPI:1790107373
Name:FLATIRON ALLERGY & ASTHMA CENTER
Entity Type:Organization
Organization Name:FLATIRON ALLERGY & ASTHMA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHOBAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-862-3303
Mailing Address - Street 1:90 HEALTH PARK DR
Mailing Address - Street 2:170
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9757
Mailing Address - Country:US
Mailing Address - Phone:303-862-3303
Mailing Address - Fax:303-862-3308
Practice Address - Street 1:90 HEALTH PARK DR
Practice Address - Street 2:170
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9757
Practice Address - Country:US
Practice Address - Phone:303-862-3303
Practice Address - Fax:303-862-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR50487207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty