Diane L Kallgren (NPI# 1144214016, PAC ID# 2567454531) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1144214016 |
| PAC ID by PECOS | 2567454531 |
| Professional Enrollment ID | I20060216000444 |
| Full Name | Diane L Kallgren |
| Organization Legal Name | KALLGREN DERMATOLOGY CLINIC, P.C. |
| Address |
3434 47th St Suite 200 Boulder CO 80301-1817 |
| Phone Number | 3034448100 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2668487489 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060027 | BOULDER COMMUNITY HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 3434 47th St, Suite 200, Boulder, CO 80301-1817 | 3034448100 | KALLGREN DERMATOLOGY CLINIC, P.C. |
| Organization Legal Name | KALLGREN DERMATOLOGY CLINIC, P.C. |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan L Rancis | Physician Assistant | Kallgren Dermatology Clinic, P.C. | 3434 47th St, Suite 200, Boulder, CO 80301-1817 |
| Amanda Lauren Lapointe | Physician Assistant | Kallgren Dermatology Clinic, P.C. | 3434 47th St, Suite 200, Boulder, CO 80301-1817 |
| Cathy Lynn Koger | Dermatology | Kallgren Dermatology Clinic, P.C. | 3434 47th St, Suite 200, Boulder, CO 80301-1817 |
| Street Address |
3434 47TH ST SUITE 200 |
| City | BOULDER |
| State | CO |
| Zip | 80301-1817 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristie M Bennett | Physical Therapy | 3434 47th St, Suite 107, Boulder, CO 80301-1817 | |
| Susan L Rancis | Physician Assistant | Kallgren Dermatology Clinic, P.C. | 3434 47th St, Suite 200, Boulder, CO 80301-1817 |
| Amanda Lauren Lapointe | Physician Assistant | Kallgren Dermatology Clinic, P.C. | 3434 47th St, Suite 200, Boulder, CO 80301-1817 |
| Cathy Lynn Koger | Dermatology | Kallgren Dermatology Clinic, P.C. | 3434 47th St, Suite 200, Boulder, CO 80301-1817 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian T Shea | Family Medicine | Sussex, Suite 1, Boulder, CO 80301 | |
| Terri D Oneby | Optometry | 1645 28th St, Boulder, CO 80301-1001 | |
| Eric P Dupuis | Optometry | Dupuis Optometry, Inc. | 1836 30th St, Boulder, CO 80301-1016 |
| Dennis P Dupuis | Optometry | Dupuis Optometry, Inc. | 1836 30th St, Boulder, CO 80301-1016 |
| Hilary B Booco | Qualified Speech Language Pathologist | Boulder Cognitive and Linguistic Center Inc | 1790 30th St, Suite 120, Boulder, CO 80301-1022 |
| Katherine L Smulligan | Physical Therapy | Boulder Cognitive and Linguistic Center Inc | 1790 30th St, Suite 120, Boulder, CO 80301-1022 |
| Nancy B Lasater | Clinical Social Worker | 1790 30th St, Suite 120, Boulder, CO 80301-1022 | |
| John H Bannwarth | Optometry | Beyer Laser Center | 1810 30th St, Suite B, Boulder, CO 80301-1025 |
| Craig F Beyer | Ophthalmology | Beyer Laser Center | 1810 30th St, Suite B, Boulder, CO 80301-1025 |
| Gail R Marcus | Clinical Social Worker | 1800 30th St, Suite 217, Boulder, CO 80301-1026 | |
| Find all physicians in zip 80301 | |||
| City | BOULDER |
| Zip Code | 80301 |
| Specialty | DERMATOLOGY |
| City + Specialty | BOULDER + DERMATOLOGY |
Please comment or provide details below to improve the information on Diane L Kallgren.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.