Provider Demographics
NPI:1235453929
Name:CANDIDA DAWN DELGATTY, M.D., PH.D., PLLC
Entity Type:Organization
Organization Name:CANDIDA DAWN DELGATTY, M.D., PH.D., PLLC
Other - Org Name:ENGLEWOOD FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDIDA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:DELGATTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:303-788-6490
Mailing Address - Street 1:701 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2736
Mailing Address - Country:US
Mailing Address - Phone:303-788-6490
Mailing Address - Fax:
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-788-6490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty