Provider Demographics
NPI:1932142023
Name:OZAKI, JOE (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:OZAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 S JUNIPER WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-6455
Mailing Address - Country:US
Mailing Address - Phone:720-280-4916
Mailing Address - Fax:720-389-8014
Practice Address - Street 1:2302 S JUNIPER WAY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-6455
Practice Address - Country:US
Practice Address - Phone:720-280-4916
Practice Address - Fax:720-389-8014
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
METD061026174400000X
CO16535174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA102955Medicare PIN
MEE97550Medicare UPIN