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NPI Code Detail

MEDICARE: COMMUNITY SPECIALTY GROUP LLC

MEDICARE: COMMUNITY SPECIALTY GROUP LLC
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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1891622650
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY SPECIALTY GROUP LLC
Provider Business Mailing Address
First Line : PO BOX 1727
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81502-1727
Country : US
Telephone Number : 970-242-0920
Fax Number :
Provider Business Practice Location Address
First Line : 2351 G RD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-9641
Country : US
Telephone Number : 970-242-0920
Fax Number :
Authorized Official
Title or Position : CREDENTIALING OFFICER
Name : DESIRAE DEGEUS
Credential :
Telephone Number : 970-263-2619
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “COMMUNITY SPECIALTY GROUP LLC ” Practice Location

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