Individual
AZIN ALIZADEHARDEBILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-8000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0003696
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA0003696
CO LICENSE
CO
Enumeration date
05/13/2013
Last updated
11/26/2014
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