Provider Demographics
NPI:1174118145
Name:ALPINE WOODS MEDICAL, PLLC
Entity type:Organization
Organization Name:ALPINE WOODS MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY CARE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-799-7473
Mailing Address - Street 1:6525 GUNPARK DR STE 370-202
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3346
Mailing Address - Country:US
Mailing Address - Phone:720-799-7473
Mailing Address - Fax:720-293-1122
Practice Address - Street 1:6525 GUNPARK DR STE 370-202
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3346
Practice Address - Country:US
Practice Address - Phone:720-799-7473
Practice Address - Fax:720-293-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty