NPI 1194340802 · live from the CMS NPI Registry
Epiphany Dermatology Of Colorado, LLC
Dermatology in Grand Junction, CO. National Provider Identifier 1194340802, active.
NPI record
| NPI | 1194340802 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 2530 N 8th St Ste 205, Grand Junction, CO 81501 |
| Practice phone | 970-245-1500 |
| Mailing address | 7300 Ranch Rd. 2222, Bldg 1, Ste 200, Austin, TX 78730 |
| Enumerated | June 9, 2020 |
| Last updated | December 7, 2023 |
| Authorized official | Gheorghe Pusta, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.