Provider Demographics
NPI:1952818411
Name:RETINA SPECIALISTS OF COLORADO PLLC
Entity Type:Organization
Organization Name:RETINA SPECIALISTS OF COLORADO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-443-2425
Mailing Address - Street 1:1444 S POTOMAC ST STE 175
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4508
Mailing Address - Country:US
Mailing Address - Phone:720-443-2425
Mailing Address - Fax:
Practice Address - Street 1:1444 S POTOMAC ST STE 175
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4508
Practice Address - Country:US
Practice Address - Phone:314-363-4057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0059415207WX0107X
261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic SurgeryGroup - Single Specialty