MOUCHANTAT PLASTIC SURGERY PC NPI 1255502753

NPI Information

  • NPI: 1255502753
  • Provider Name: MOUCHANTAT PLASTIC SURGERY PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Former Legal Business Name: JOHN M PAV MD PC
  • Address: 3280 WADSWORTH BLVD
    SUITE 100
    WHEAT RIDGE, CO
    ZIP 80033
  • Phone: (303) 232-8585

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NPI Details

MOUCHANTAT PLASTIC SURGERY PC is a specialist in Wheat Ridge, CO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MOUCHANTAT PLASTIC SURGERY PC NPI is 1255502753. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is John M Pav Md Pc.

The provider's business location address is:

3280 WADSWORTH BLVD
SUITE 100
WHEAT RIDGE, CO
ZIP 80033-640
Phone: (303) 232-8585
Fax: (303) 232-3304

The provider's authorized official is Richard A Mouchantat .
The authorized official title is Physician/owner and has the following contact phone number (303) 232-8585.

The enumeration date for this NPI number is 3/12/2008 and was last updated on 9/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CS4008MEDICARE PINCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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