| Advanced Life Care Medical Group | |
|
2255 S 88th St Louisville CO 80027-9716 | |
| (303) 673-9990 | |
| (949) 208-6981 |
| Full Name | Advanced Life Care Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2255 S 88th St, Louisville, Colorado |
| Authorized Official Name and Position | Michael A Zona (OWNER) |
| Authorized Official Contact | 3102610035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Life Care Medical Group Po Box 819 Niwot CO 80544-0819 Ph: (310) 261-0035 | Advanced Life Care Medical Group 2255 S 88th St Louisville CO 80027-9716 Ph: (303) 673-9990 |
| NPI Number | 1093749012 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 01/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093749012 | NPI | - | NPPES |
| ZZZ48692Z | Other | CA | BLUE SHIELD |
| CN3641 | Other | CA | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G66875 (California) | Primary |
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