Individual
DR. DERIC J RACHJAIBUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
207Q00000X
Family Medicine Physician
Primary
41861
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31930743
—
CO
05
—
57474524
—
CO
Enumeration date
09/20/2006
Last updated
04/23/2019
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