Basic Information
Provider Information
NPI: 1063426088
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRIKHA
FirstName: ANITA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 JACKSON ST
Address2:  
City: DENVER
State: CO
PostalCode: 802062761
CountryCode: US
TelephoneNumber: 3033884461
FaxNumber: 3032702174
Practice Location
Address1: 1400 JACKSON ST
Address2:  
City: DENVER
State: CO
PostalCode: 802062761
CountryCode: US
TelephoneNumber: 3033884461
FaxNumber: 3032702174
Other Information
ProviderEnumerationDate: 07/27/2006
LastUpdateDate: 08/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207K00000X51818COY Allopathic & Osteopathic PhysiciansAllergy & Immunology 
207R00000X51818CON Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
5993673805CO MEDICAID


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