A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Non-Pharmacy Dispensing Site |
332900000X | 87 | All Other Suppliers | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine |
| NPI Number | 1346632684 |
| LBN Legal business name | OPTUMCARE COLORADO MEDICAL GROUP LLC |
| Authorized official | EMILY CASTILLO - (ASSOCIATE DIRECTOR CREDENTIALING) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/24/2015 |
| Last updated | 08/20/2024 - More than a year ago |
| Identifiers | n/a |
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