Provider Demographics
NPI:1700813391
Name:SARRAFIZADEH, RAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:
Last Name:SARRAFIZADEH
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 1:2770 N UNION BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1183
Mailing Address - Country:US
Mailing Address - Phone:719-473-9595
Mailing Address - Fax:719-227-0669
Practice Address - Street 1:2770 N UNION BLVD
Practice Address - Street 2:STE 140
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1183
Practice Address - Country:US
Practice Address - Phone:719-473-9595
Practice Address - Fax:719-227-0669
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0054395207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93008716Medicaid
H02921Medicare UPIN
MI4266469Medicaid
OM21980018Medicare ID - Type Unspecified