Organization
LEGACY PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERIC J RACHJAIBUN MD (OWNER)
(720) 928-0244
Entity
Organization
Contact information
Practice address
11990 GRANT ST STE 110, NORTHGLENN, CO 80233-1122
(720) 928-0244
(720) 928-0247
Mailing address
11990 GRANT ST STE 110, NORTHGLENN, CO 80233-1122
(720) 928-0244
(720) 928-0247
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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