Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 48434 | CO |
NPI | 1285830034 |
---|---|
Provider Name | Carlos Barajas |
First Address | Denver, CO 80218-2962 |
Second Address | Englewood, CO 80113-2702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 23/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25870564 | (05) | CO |