Organization
OBSTETRIX MEDICAL GROUP OF COLORADO, P.C.
Active
Other names
Rocky Mountain Pediatric Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD P PORRECO MD (PRESIDENT)
(954) 384-0175
Entity
Organization
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
4722 N 24TH ST STE 150, PHOENIX, AZ 85016-4860
(877) 737-4546
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73805033
—
CO
Enumeration date
06/03/2020
Last updated
06/03/2020
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