Provider Demographics
NPI:1780971853
Name:ORTEGA, CAMILO ANDRES (MD)
Entity type:Individual
Prefix:DR
First Name:CAMILO
Middle Name:ANDRES
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CAMILO
Other - Middle Name:ANDRES
Other - Last Name:ORTEGA PARRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9049
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-9049
Mailing Address - Country:US
Mailing Address - Phone:303-415-4101
Mailing Address - Fax:303-415-4769
Practice Address - Street 1:5495 ARAPAHOE AVE STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1224
Practice Address - Country:US
Practice Address - Phone:303-415-4250
Practice Address - Fax:303-440-9629
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201401579207R00000X
CODR.0073829207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine