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Individual

VONGPHETH LUANGPHAXAY MCCARTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1501 S POTOMAC ST, AURORA, CO 80012-5411
(303) 306-7783
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
48651
CO
208000000X
Pediatrics Physician
MD00046618
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8459422
WA
05
95002782
CO
01
P00835980
RAILROAD PIN
CO
Enumeration date
10/14/2006
Last updated
04/01/2014
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