Provider Demographics
NPI:1336139534
Name:BREGNI-PAGE, CARLA T (DO)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:T
Last Name:BREGNI-PAGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2356 MEADOWS BLVD
Mailing Address - Street 2:STE 140B
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8405
Mailing Address - Country:US
Mailing Address - Phone:303-218-7774
Mailing Address - Fax:303-660-5065
Practice Address - Street 1:2356 MEADOWS BLVD
Practice Address - Street 2:STE 140B
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8405
Practice Address - Country:US
Practice Address - Phone:303-218-7774
Practice Address - Fax:303-660-5065
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012799207Q00000X
CODR.0056781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC5963OtherMCARE
MI080D410020OtherBLUE CROSS BLUE SHIELD
MI080D410020OtherBLUE CARE NETWORK
MI0852501625OtherBLUE CROSS BLUE SHIELD
MI080D410020OtherBLUE CROSS COMMUNITY BLUE
MIG74585OtherHEALTH ALLIANCE PLAN
MIG74585OtherHEALTH NET SERVICES
MI204388OtherHEALTH ADVANTAGE NETWORK
MI3486424001OtherCIGNA
CODR.0056781OtherCOLORADO STATE LICENSE
MI080126360OtherMETRAHEALTH
MI204388OtherMCLAREN HEALTH PLAN
MI080D4100220OtherBLUE CROSS POS
MI5274804OtherAETNA
MI0983187OtherHEATLTH PLUS
MI3464872Medicaid
MI0983187OtherHEATLTH PLUS
MI0M28430063Medicare ID - Type Unspecified