OBREGON, RICHARD G (MD)

Provider Demographics

• NPI: 1558317255
• Name: OBREGON, RICHARD G (MD)
• Entity Type: Individual
• First Name: RICHARD
• Middle Name: G
• Last Name: OBREGON
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 10800 E GEDDES AVE STE 300
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3895
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 501 E HAMPDEN AVE
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80113-2702
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2006-05-25
• Last Update Date: 2024-03-29

Provider Licenses

State	License ID	Taxonomies
KS	04-36342	2085R0202X
HI	17557	2085R0202X
NE	25000	2085R0202X
CO	31650	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CO	300105010	Other	RR RIA MEDICARE
CO	01316504	Medicaid
WY	1558317255	Medicaid
KS	200425600A	Medicaid
NE	84-059792913	Medicaid
WI	99112118	Medicaid
OH	1558317255/2975482	Medicaid
CO	300110201	Other	RR MIC MEDICARE
NE	10025709000	Medicaid
NV	1558317255	Medicaid
AL	1558317255	Medicaid
NE	P00720351	Other	RR MCR NE
IA	0597955	Medicaid
CA	1558317255	Medicaid
MI	104686276	Medicaid
TX	204669001	Medicaid
HI	0000343806	Other	HMSA ALL PRODUCTS
AZ	925993	Medicaid
OH	1558317255/2975482	Medicaid
HI	0000343806	Other	HMSA ALL PRODUCTS
WY	1558317255	Medicaid
CO	01316504	Medicaid
IA	0597955	Medicaid
KS	KA3249036	Medicare PIN
NE	NA1214021	Medicare PIN
CO	C211668	Medicare PIN
HI	H105451	Medicare PIN
NV	1558317255	Medicaid
CA	1558317255	Medicaid
TX	204669001	Medicaid
HI	H105452	Medicare PIN
NE	NA1215021	Medicare PIN