Basic Information
| Provider Information | |||||||||
| NPI: | 1477812667 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY OF COLORADO HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1665 AURORA COURT | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208480000 | ||||||||
| FaxNumber: | 7208480359 | ||||||||
| Practice Location | |||||||||
| Address1: | 1665 AURORA COURT | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208480000 | ||||||||
| FaxNumber: | 7208480359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2012 | ||||||||
| LastUpdateDate: | 05/09/2012 | ||||||||
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| AuthorizedOfficialLastName: | MAMI | ||||||||
| AuthorizedOfficialFirstName: | CAMILLE | ||||||||
| AuthorizedOfficialMiddleName: | GONZALEZ | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL HEALTH PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 7208480000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | NLC12526 | CO | Y | Hospitals | Special Hospital |
No ID Information.