Provider Demographics
NPI:1366047086
Name:BABALMORAD, AHSUN
Entity type:Individual
Prefix:
First Name:AHSUN
Middle Name:
Last Name:BABALMORAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 S PARKER RD STE 203
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-8068
Mailing Address - Country:US
Mailing Address - Phone:720-760-5814
Mailing Address - Fax:
Practice Address - Street 1:1260 S PARKER RD STE 203
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-8068
Practice Address - Country:US
Practice Address - Phone:303-534-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist