Healthcare Provider Details

I. General information

NPI: 1851303002
Provider Name (Legal Business Name): LESLIE GAMACHE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE CLAIRE SALBENBLATT MD

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE STE 4350 SUITE 454
DENVER CO
80218-1253
US

IV. Provider business mailing address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-228-1240
  • Fax: 303-228-1250
Mailing address:
  • Phone: 303-228-1240
  • Fax: 303-228-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number44771
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: