Provider Demographics
NPI:1831579085
Name:ALIZADEH, POURAN POUNEH (DO)
Entity type:Individual
Prefix:
First Name:POURAN
Middle Name:POUNEH
Last Name:ALIZADEH
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 WARD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5610 WARD RD STE 300
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1309
Practice Address - Country:US
Practice Address - Phone:970-236-8093
Practice Address - Fax:855-825-1540
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCDRH.0059471207Q00000X
DEC2-0024269207V00000X
IDO-1818207V00000X
CODR.0059471207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine