Provider Demographics
NPI:1417063058
Name:PEAK ANESTHESIA AND PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:PEAK ANESTHESIA AND PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GESQUIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-870-7446
Mailing Address - Street 1:PO BOX 3274
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80155-3274
Mailing Address - Country:US
Mailing Address - Phone:720-870-7446
Mailing Address - Fax:720-870-7460
Practice Address - Street 1:14100 E ARAPAHOE RD
Practice Address - Street 2:SUITE B110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4028
Practice Address - Country:US
Practice Address - Phone:720-870-7446
Practice Address - Fax:720-870-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65153375Medicaid
COC806808Medicare PIN