Provider Demographics
NPI:1124024799
Name:CREEKSIDE ENDOCRINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:CREEKSIDE ENDOCRINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZEMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-388-6410
Mailing Address - Street 1:4101 E. LOUISIANA AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3431
Mailing Address - Country:US
Mailing Address - Phone:303-388-6410
Mailing Address - Fax:303-388-1069
Practice Address - Street 1:4101 E. LOUISIANA AVE
Practice Address - Street 2:STE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-3431
Practice Address - Country:US
Practice Address - Phone:303-388-6410
Practice Address - Fax:303-388-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27647207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60089024Medicaid
CODD3981OtherRR MEDICARE
COC498458Medicare PIN
CO60089024Medicaid