=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295787950
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PANORAMA ORTHOPEDICS AND SPINE CENTER PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2006
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 660 GOLDEN RIDGE RD SUITE 250
-----------------------------------------------------
City | GOLDEN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-233-1223
-----------------------------------------------------
Fax | 303-233-8755
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 660 GOLDEN RIDGE RD STE 250
-----------------------------------------------------
City | GOLDEN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80401-9541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-233-1223
-----------------------------------------------------
Fax | 303-233-8755
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CHARLES GOTTLOB
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 303-233-1223
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------