Healthcare Provider Details

I. General information

NPI: 1316663669
Provider Name (Legal Business Name): PANORAMA ORTHOPEDICS AND SPINE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E HARVARD AVE STE 155
DENVER CO
80210-5031
US

IV. Provider business mailing address

660 GOLDEN RIDGE RD
GOLDEN CO
80401-9541
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-1223
  • Fax:
Mailing address:
  • Phone: 303-233-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES A. GOTTLOB
Title or Position: PRESIDENT
Credential: MD
Phone: 303-274-7321