Individual
FAYIZ MAHGOUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5305 SPINE RD STE B, BOULDER, CO 80301-3331
(970) 402-5789
Mailing address
501 W PROSPECT RD APT 33B, FORT COLLINS, CO 80526-2052
(970) 402-5789
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/11/2021
Last updated
12/11/2021
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