Provider Demographics
NPI:1033494190
Name:KOVAR, SUNNI LEE
Entity type:Individual
Prefix:
First Name:SUNNI
Middle Name:LEE
Last Name:KOVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 E MEXICO AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3941
Mailing Address - Country:US
Mailing Address - Phone:720-524-1001
Mailing Address - Fax:720-302-1755
Practice Address - Street 1:10520 EL DIENTE CT
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-2656
Practice Address - Country:US
Practice Address - Phone:720-524-1001
Practice Address - Fax:303-792-3028
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3070152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist