Healthcare Provider Details

I. General information

NPI: 1922397629
Provider Name (Legal Business Name): KATHRYN M GINDER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15101 E ILIFF AVE STE 140
AURORA CO
80014-4548
US

IV. Provider business mailing address

15101 E ILIFF AVE STE 140
AURORA CO
80014-4548
US

V. Phone/Fax

Practice location:
  • Phone: 303-996-9601
  • Fax:
Mailing address:
  • Phone: 303-996-9601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A11664
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number52555
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: