Healthcare Provider Details

I. General information

NPI: 1679956668
Provider Name (Legal Business Name): DYLAN GALLACHER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E HARVARD AVE STE 570
DENVER CO
80210-7003
US

IV. Provider business mailing address

950 E HARVARD AVE STE 570
DENVER CO
80210-7003
US

V. Phone/Fax

Practice location:
  • Phone: 303-381-0929
  • Fax: 303-381-1566
Mailing address:
  • Phone: 303-381-0929
  • Fax: 303-381-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0006336
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: