Provider Demographics
NPI:1013157189
Name:DR REVELYN G ARROGANTE MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR REVELYN G ARROGANTE MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REVELYN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARROGANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-999-9864
Mailing Address - Street 1:1437 DENVER AVE
Mailing Address - Street 2:#128
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5226
Mailing Address - Country:US
Mailing Address - Phone:303-761-1215
Mailing Address - Fax:303-762-1701
Practice Address - Street 1:4401 UNION ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-2800
Practice Address - Country:US
Practice Address - Phone:970-619-3400
Practice Address - Fax:970-278-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20322089Medicaid
WY133993100Medicaid
COCOAAA4412Medicare PIN