Provider Demographics
NPI:1356972129
Name:FMC-CAHEP AURORA
Entity type:Organization
Organization Name:FMC-CAHEP AURORA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALOK
Authorized Official - Middle Name:
Authorized Official - Last Name:SARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-954-0058
Mailing Address - Street 1:5250 LEETSDALE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1450
Mailing Address - Country:US
Mailing Address - Phone:303-954-0058
Mailing Address - Fax:303-997-6325
Practice Address - Street 1:5250 LEETSDALE DR STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1450
Practice Address - Country:US
Practice Address - Phone:303-954-0058
Practice Address - Fax:303-997-6325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY MEDICINE CLINIC FOR HEALTH EQUITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29606888Medicaid