Individual
DR. GLENN TETSUO KIMATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8771 WOLFF CT, SUITE 115, WESTMINSTER, CO 80031-6948
(303) 650-8005
(303) 412-5891
Mailing address
8771 WOLFF CT, SUITE 115, WESTMINSTER, CO 80031-6948
(303) 650-8005
(303) 412-5891
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24239
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073386
VALUE OPTIONS
—
01
—
186554300
OWCP
—
01
—
32557
FEDERAL BLUE CROSS & BLUE
—
Enumeration date
01/19/2007
Last updated
03/11/2008
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