Provider Demographics
NPI:1053913129
Name:CENTER FOR COSMETIC SURGERY PC
Entity type:Organization
Organization Name:CENTER FOR COSMETIC SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:QUDDUS
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-278-2600
Mailing Address - Street 1:725 HERITAGE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3673
Mailing Address - Country:US
Mailing Address - Phone:303-278-2600
Mailing Address - Fax:
Practice Address - Street 1:725 HERITAGE RD STE 100
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3673
Practice Address - Country:US
Practice Address - Phone:303-278-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty