Provider Demographics
NPI:1962166108
Name:SOTOMAYOR, GERARDO GABRIEL (DC)
Entity type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:GABRIEL
Last Name:SOTOMAYOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-3586
Mailing Address - Country:US
Mailing Address - Phone:303-922-8146
Mailing Address - Fax:303-922-0158
Practice Address - Street 1:945 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-3586
Practice Address - Country:US
Practice Address - Phone:303-922-8146
Practice Address - Fax:303-922-0158
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor