Provider Demographics
NPI:1548382781
Name:MOUNTAINVIEW FAMILY MEDICINE, PC
Entity Type:Organization
Organization Name:MOUNTAINVIEW FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEGLEITNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-759-4800
Mailing Address - Street 1:2020 S ONEIDA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2447
Mailing Address - Country:US
Mailing Address - Phone:303-759-4800
Mailing Address - Fax:303-759-0509
Practice Address - Street 1:2020 S ONEIDA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2447
Practice Address - Country:US
Practice Address - Phone:303-759-4800
Practice Address - Fax:303-759-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COMOF8808OtherBCBS NUMBER
CO06D0866621OtherCLEA NUMBER
COMOF8808OtherBCBS NUMBER