# INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** Wheat Ridge Clinic - Diabetes & Endocrinology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760094585
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP FIANANCE)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 3555 LUTHERAN PKWY STE 180, WHEAT RIDGE, CO 80033-6000
- **Practice address phone:** (303) 403-7933
- **Practice address fax:** (303) 403-7945
- **Mailing address:** 500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
- **Mailing address phone:** (303) 272-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2020
- **Last updated:** 06/28/2024