Provider Demographics
NPI:1972707610
Name:PADRON, GABRIEL (CMT)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:PADRON
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 17TH ST STE 1825
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3522
Mailing Address - Country:US
Mailing Address - Phone:303-688-3914
Mailing Address - Fax:
Practice Address - Street 1:900 CASTLETON RD STE 100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-7548
Practice Address - Country:US
Practice Address - Phone:303-688-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NOT APPLICABLE225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist