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
—
—
207R00000X
Internal Medicine Physician
—
—
261QE0002X
Emergency Care Clinic/Center
—
CO
332900000X
Non-Pharmacy Dispensing Site
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06085288
—
CO
Enumeration date
03/07/2014
Last updated
08/20/2024
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