# INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** Candelas Clinic - Podiatry, Candelas Clinic - Primary Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043973902
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP FINANCE MED GROUP)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 15389 W 91ST DR STE 100, ARVADA, CO 80007-1400
- **Practice address phone:** (303) 603-9300
- **Practice address fax:** (720) 501-6699
- **Mailing address:** 500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
- **Mailing address phone:** (303) 272-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP1100X | Podiatric Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/18/2021
- **Last updated:** 06/28/2024