1518256288 NPI number — MRS. REBEKAH RUTH GAENSBAUER MB,BAO, BCH

Table of content: MRS. REBEKAH RUTH GAENSBAUER MB,BAO, BCH (NPI 1518256288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518256288 NPI number — MRS. REBEKAH RUTH GAENSBAUER MB,BAO, BCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAENSBAUER
Provider First Name:
REBEKAH
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MB,BAO, BCH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHWARTZ
Provider Other First Name:
REBEKAH
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518256288
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1850 NIAGARA STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80220-1747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-431-1928
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13001 E. 17TH PLACE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF COLORADO DENVER SCHOOL OF MEDICINE GME
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-724-6031
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: DR.0054418 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)