# OPTUMCARE COLORADO MEDICAL GROUP LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OPTUMCARE COLORADO MEDICAL GROUP LLC
- **Other names:** Optum Colorado Springs Powers 6340
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1396586152
- **Legal business name:** OPTUMCARE COLORADO MEDICAL GROUP LLC
- **Authorized official:** EMILY CASTILLO (ASSOCIATE DIRECTOR CREDENTIALING)
- **Authorized official phone:** (702) 579-3253

## Contact information

- **Practice address:** 6340 BARNES RD, COLORADO SPRINGS, CO 80922-2602
- **Practice address phone:** (719) 522-1133
- **Mailing address:** PO BOX 35380, LAS VEGAS, NV 89133-5380
- **Mailing address phone:** (719) 400-7470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2024
- **Last updated:** 08/20/2024