Provider Demographics
NPI:1679741466
Name:ARVIN K RAO MD PROF LLC
Entity type:Organization
Organization Name:ARVIN K RAO MD PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-953-6767
Mailing Address - Street 1:6650 SOUTH VINE STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2740
Mailing Address - Country:US
Mailing Address - Phone:303-953-6767
Mailing Address - Fax:303-740-9311
Practice Address - Street 1:15 W DRY CREEK CIR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4485
Practice Address - Country:US
Practice Address - Phone:303-953-6767
Practice Address - Fax:303-740-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97880523Medicaid