Provider Demographics
NPI:1831621978
Name:NOGUCHI, JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:NOGUCHI
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 1:101 ERIE PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-4072
Mailing Address - Country:US
Mailing Address - Phone:720-526-0010
Mailing Address - Fax:
Practice Address - Street 1:13772 DENVER WEST PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3139
Practice Address - Country:US
Practice Address - Phone:303-273-8783
Practice Address - Fax:303-279-9140
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA169040207W00000X, 207W00000X
CODR.0070010207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery