Provider Demographics
NPI:1215543699
Name:COLORADO PHYSICIAN PARTNERS, PLLC
Entity Type:Organization
Organization Name:COLORADO PHYSICIAN PARTNERS, PLLC
Other - Org Name:LITTLETON INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-798-9996
Mailing Address - Street 1:205 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2843
Mailing Address - Country:US
Mailing Address - Phone:720-728-5170
Mailing Address - Fax:720-866-9967
Practice Address - Street 1:7780 S BROADWAY STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2633
Practice Address - Country:US
Practice Address - Phone:303-798-9996
Practice Address - Fax:303-730-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11936860Medicaid