| NPI | 1659641900 |
|---|---|
| Former Legal Business Name | OPTUMCARE COLORADO SPRINGS LLC |
| Former Legal Business Name | DAVITA MEDICAL GROUP COLORADO SPRINGS LLC |
| Former Legal Business Name | COLORADO SPRINGS HEALTH PARTNERS LLC |
| Doing Business As | OPTUM COLORADO SPRINGS |
| Entity Type | Organization |
| Authorized Contact | EMILY CASTILLO Associate Director Credentialing 702-579-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0900X Dermatology, Dermatopathology | |
| 207Q00000X Family Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 208D00000X General Practice | |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2024-08-20 |