INTERMOUNTAIN MEDICAL GROUP DENVER LLC NPI 1760090146

NPI Information

  • NPI: 1760090146
  • Provider Name: INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: QUAIL CREEK CLINIC
  • CLIA Number: 06D2210312
  • Address: 2055 W 136TH AVE STE B118
    BROOMFIELD, CO
    ZIP 80023
  • Phone: (303) 673-1570

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NPI Details

INTERMOUNTAIN MEDICAL GROUP DENVER, LLC is a family medicine in Broomfield, CO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. INTERMOUNTAIN MEDICAL GROUP DENVER, LLC NPI is 1760090146. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Quail Creek Clinic.

The provider's business location address is:

2055 W 136TH AVE STE B118
BROOMFIELD, CO
ZIP 80023-308
Phone: (303) 673-1570
Fax: (303) 673-1331

The provider's authorized official is Jon Mcdaniel .
The authorized official title is Vp Of Finance and has the following contact phone number (303) 272-0231.

The CLIA number assigned to this NPI record is 06D2210312 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/21/2020 and was last updated on 6/28/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 3/30/2025

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