Organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Active
Other names
OptumCare Colorado Springs LLC, Optum Colorado Springs - Monument, Colorado Springs Health Partners LLC, DaVita Medical Group Colorado Springs LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR CREDENTIALING)
(702) 579-3253
Entity
Organization
Contact information
Practice address
15909 JACKSON CREEK PKWY, MONUMENT, CO 80132-8693
(719) 488-9933
(719) 488-7396
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
02/24/2015
Last updated
08/20/2024
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