Organization
MOUNTAIN VIEW MEDICAL GROUP, LLC
Active
Other names
DaVita Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE MINEAR (CHIEF EXECUTIVE OFFICER)
(719) 590-1177
Entity
Organization
Contact information
Practice address
5014 EL CAMINO DR, COLORADO SPRINGS, CO 80918-2104
(719) 635-7700
(719) 635-1794
Mailing address
5575 TECH CENTER DR, STE. 106, COLORADO SPRINGS, CO 80919-2353
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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