Organization
DERIC RACHJAIBUN, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERIK RACHJAIBUN M.D. (OWNER)
(303) 355-7414
Entity
Organization
Contact information
Practice address
1750 RACE ST, DENVER, CO 80206-1114
(303) 355-7414
Mailing address
1750 RACE ST, DENVER, CO 80206-1114
(303) 355-7414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41861
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16020332
—
CO
Enumeration date
09/04/2007
Last updated
11/19/2008
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