Provider Demographics
NPI:1427891068
Name:FRONT RANGE RETINA, P.C.
Entity type:Organization
Organization Name:FRONT RANGE RETINA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-828-3937
Mailing Address - Street 1:3740 DACORO LN STE 145
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-2504
Mailing Address - Country:US
Mailing Address - Phone:720-828-3937
Mailing Address - Fax:720-405-4355
Practice Address - Street 1:1710 JET STREAM DR STE 215
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3937
Practice Address - Country:US
Practice Address - Phone:720-828-3937
Practice Address - Fax:720-405-4355
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRONT RANGE RETINA, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty