Organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Active
Parent organization
OPTUMCARE COLORADO MEDICAL GROUP LLC
Other names
Colorado Springs Health Partners LLC, OptumCare Colorado Springs LLC, Optum Colorado Springs at Colorado College, DaVita Medical Group Colorado Springs LLC
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
1106 N CASCADE AVE, COLORADO SPRINGS, CO 80903-1355
(719) 389-6384
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04740080
—
CO
Enumeration date
09/25/2012
Last updated
08/20/2024
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