Provider Demographics
NPI:1043651706
Name:WESTGATE, KAITLYN M (DO)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:M
Last Name:WESTGATE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:CHRISTOPHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11245 HURON ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2806
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:11245 HURON ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2806
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL4774207Q00000X
IN02005658A208M00000X
CODR.0057477207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO027314OtherKAISER COMMERCIAL NUMBER
CO17970512Medicaid
CO545244YK5YMedicare PIN