Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | DR.0028923 | CO |
NPI | 1003887738 |
---|---|
Provider Name | Dr. Leon Samuel Greos |
First Address | Denver, CO 80230-6429 |
Second Address | Centennial, CO 80112-3913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 04/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01289230 | (05) | CO |
E41170 | (02) | CO |