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Organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Active
Organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Active
Other names
OptumCare Colorado Springs LLC, Colorado Springs Health Partners LLC, DaVita Medical Group Colorado Springs LLC, Optum Colorado Springs - Roundhouse
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR CREDENTIALING)
(702) 579-3253
Entity
Organization
Contact information
Practice address
600 S 21ST ST UNIT 100, COLORADO SPRINGS, CO 80904-3763
(719) 522-1133
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
(719) 538-2997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
261QE0002X
Emergency Care Clinic/Center
—
CO
332900000X
Non-Pharmacy Dispensing Site
—
CO
Other
Enumeration date
03/07/2014
Last updated
08/20/2024
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