A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | General Practice | 208D00000X |
| Family Medicine | 207Q00000X | |
| Internal Medicine | 207R00000X | |
| Non-Pharmacy Dispensing Site | 332900000X | |
| Pediatrics | 208000000X |
* Indicates primary specialty
| NPI Number | 1346632684 |
| Legal business name LBN |
OPTUMCARE COLORADO MEDICAL GROUP LLC |
| Authorized official | EMILY CASTILLO - (ASSOCIATE DIRECTOR CREDENTIALING) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 02/24/2015 |
| Last updated | 08/20/2024 - More than a year ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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