Provider Demographics
NPI:1316960347
Name:KASTEN PRICE, LISA BERNADETTE (MD FACP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BERNADETTE
Last Name:KASTEN PRICE
Suffix:
Gender:F
Credentials:MD FACP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KASTEN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1125-17TH STREET
Mailing Address - Street 2:# 1000
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202
Mailing Address - Country:US
Mailing Address - Phone:720-612-6600
Mailing Address - Fax:
Practice Address - Street 1:1445 DAYTON ST DAWN CLINIC
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010
Practice Address - Country:US
Practice Address - Phone:303-800-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37916207RG0300X, 208M00000X
CODR.0037916208M00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07457251Medicaid
CO451068Medicare ID - Type Unspecified
COH54356Medicare UPIN