Organization
EPIPHANY DERMATOLOGY OF COLORADO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (CEO)
(512) 960-5760
Entity
Organization
Contact information
Practice address
2530 N 8TH ST STE 205, GRAND JUNCTION, CO 81501-8858
(970) 245-1500
Mailing address
7300 RANCH RD. 2222, BLDG 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
12/07/2023
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