Basic Information
| Provider Information | |||||||||
| NPI: | 1518256288 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAENSBAUER | ||||||||
| FirstName: | REBEKAH | ||||||||
| MiddleName: | RUTH | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MB,BAO, BCH | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SCHWARTZ | ||||||||
| OtherFirstName: | REBEKAH | ||||||||
| OtherMiddleName: | RUTH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1850 NIAGARA STREET | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802201747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204311928 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13001 E. 17TH PLACE | ||||||||
| Address2: | UNIVERSITY OF COLORADO DENVER SCHOOL OF MEDICINE GME | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800450000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037246031 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2011 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | DR.0054418 | CO | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.