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General NPI Number Information
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NPI Number | 1689022360
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Entity Type | Individual
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Provider Name | OLGA GORSHKALOVA D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 12605 E 16TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2545
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Country | US
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Telephone | 720-848-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110429
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City | AURORA
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State | CO
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Zip | 80042-0429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DO.OP.61240620-IMLC
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | CDRH.0067126
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License Number State | CO
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