Provider Demographics
NPI:1457514739
Name:COLORADO WOMEN'S HEALTHCARE INC
Entity Type:Organization
Organization Name:COLORADO WOMEN'S HEALTHCARE INC
Other - Org Name:GRACE CHENG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:YUN
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:3037-458-8888
Mailing Address - Street 1:1550 SOUT POTOMAC ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-9998
Mailing Address - Country:US
Mailing Address - Phone:303-745-8888
Mailing Address - Fax:303-369-1062
Practice Address - Street 1:1550 S POTOMAC ST
Practice Address - Street 2:SUITE 135
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5455
Practice Address - Country:US
Practice Address - Phone:303-745-8888
Practice Address - Fax:303-369-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37990174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO70823774Medicaid
COC534638Medicare PIN