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OPTUMCARE COLORADO MEDICAL GROUP LLC NPI 1407487788


NPI Information

NPI: 1407487788
Provider Name: OPTUMCARE COLORADO MEDICAL GROUP LLC

Doing Business As: BROADMOOR VALLEY PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 06D0894940

Address:
1230 TENDERFOOT HILL RD STE 255
COLORADO SPRINGS, CO
ZIP 80906
Phone: (719) 576-5437
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OPTUMCARE COLORADO MEDICAL GROUP LLC is a pediatrics in Colorado Springs, CO. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. OPTUMCARE COLORADO MEDICAL GROUP LLC NPI is 1407487788. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Broadmoor Valley Pediatrics.

The provider's business location address is:

1230 TENDERFOOT HILL RD STE 255
COLORADO SPRINGS, CO
ZIP 80906-393
Phone: (719) 576-5437
Fax: (719) 576-5441

The provider's authorized official is David I Cohen .
The authorized official title is Medical Director and has the following contact phone number (702) 480-2550.

The CLIA number assigned to this NPI record is 06D0894940 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/27/2020 and was last updated on 3/7/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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