Organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Active
Parent organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Other names
Optumcare Colorado Springs LLC, MDVIP DR THEODORE LAWSON
Organization subpart
Yes
Provider details
NPI number
Legal business name
OPTUMCARE COLORADO MEDICAL GROUP LLC
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR CREDENTIALING)
(702) 579-3253
Entity
Organization
Contact information
Practice address
3470 CENTENNIAL BLVD STE 210, COLORADO SPRINGS, CO 80907-8669
(719) 463-5600
(719) 538-2990
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
(719) 538-2990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
08/20/2024
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