MEDICARE: PANORAMA ORTHOPEDICS & SPINE CENTER, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	2085R0202X	Diagnostic Radiology Physician
3	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	CR5408	OTHER	CO	MEDICAIRE

General Provider Information

NPI Number	:	1295355766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANORAMA ORTHOPEDICS & SPINE CENTER, PC

Provider Business Mailing Address
First Line	:	660 GOLDEN RIDGE RD STE 250
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80401-9541
Country	:	US
Telephone Number	:	303-233-1223
Fax Number	:	303-233-8755

Provider Business Practice Location Address
First Line	:	640 PLAZA DR STE 300
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2399
Country	:	US
Telephone Number	:	303-233-1223
Fax Number	:	303-233-8755

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHARLES A. GOTTLOB
Credential	:	MD
Telephone Number	:	303-274-7321

Provider Enumeration Date	:	04/24/2020
Last Update Date	:	05/21/2026

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Directions to “PANORAMA ORTHOPEDICS & SPINE CENTER, PC ” Practice Location

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