Organization
PREMIER ALLERGY & ASTHMA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAWEEWAN HOONTRAKOON (OWNER)
(303) 468-8668
Entity
Organization
Contact information
Practice address
19245 E SMOKY HILL RD UNIT A, CENTENNIAL, CO 80015-3122
(303) 468-8668
(303) 468-8669
Mailing address
19245 E SMOKY HILL RD UNIT A, CENTENNIAL, CO 80015-3122
(303) 468-8668
(303) 468-8669
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR670514
ANTHEM BLUE SHIELD
CO
Enumeration date
05/01/2007
Last updated
09/05/2020
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