Basic Information
Provider Information
NPI: 1598716482
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BABAEI
FirstName: ARASH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 JACKSON ST
Address2:  
City: DENVER
State: CO
PostalCode: 802062762
CountryCode: US
TelephoneNumber: 3033884461
FaxNumber: 3033981211
Practice Location
Address1: 1400 JACKSON ST
Address2:  
City: DENVER
State: CO
PostalCode: 80206
CountryCode: US
TelephoneNumber: 3033884461
FaxNumber: 3033981211
Other Information
ProviderEnumerationDate: 05/15/2006
LastUpdateDate: 02/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X60613COY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
159871648205CO MEDICAID


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