MEDICARE: CAREMORE MEDICAL GROUP OF COLORADO, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1639658271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREMORE MEDICAL GROUP OF COLORADO, P.C.

Provider Business Mailing Address
First Line	:	12900 PARK PLAZA DR STE 150
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-9329
Country	:	US
Telephone Number	:	888-291-1358
Fax Number	:

Provider Business Practice Location Address
First Line	:	1531 MARKET ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202
Country	:	US
Telephone Number	:	844-545-0230
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MILISH RISBOOD
Credential	:	MD
Telephone Number	:	888-291-1358

Provider Enumeration Date	:	08/13/2018
Last Update Date	:	09/25/2018

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