| Provider / Organization | NPI | Date Certified |
|---|---|---|
| WEI-SAN MONDIE | 1013493220 | 2018-07-11 |
Wei-san Mondie is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1013493220. Registration indicates Wei-san Mondie is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Wei-san Mondie |
| Practice Office Address | DENVER HEALTH LOWRY FAMILY HEALTH CENTER 1001 YOSEMITE ST DENVER, CO US |
| Practice Office Telephone | 3036024545 |
| Mailing Address | 1795 S BANNOCK ST APT 7-207 DENVER, CO 802233631 US |
| Business Telephone | 8178912936 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1125 Madison St | Jefferson City, MO 651015227 | 5736325000 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | TL.0007785
CO |
| 207Q00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | DR.0065867
CO |
| 2018024679 | MEDICAID | MO | |
| DR.0065867 | OTHER | CO | COLORADO MEDICA |