Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | DR.0064658 | CO |
NPI | 1114330297 |
---|---|
Provider Name | Dr. Michael Jason Bozzella |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2014 |
Last Update Date | 03/08/2020 |