Healthcare Provider Details

I. General information

NPI: 1992288385
Provider Name (Legal Business Name): DENVER FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 S FEDERAL BLVD
DENVER CO
80219-4898
US

IV. Provider business mailing address

1701 S FEDERAL BLVD
DENVER CO
80219-4898
US

V. Phone/Fax

Practice location:
  • Phone: 303-936-1760
  • Fax: 303-934-4036
Mailing address:
  • Phone: 303-936-1760
  • Fax: 303-934-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY N VANBANG
Title or Position: DIRECTOR
Credential:
Phone: 408-307-0560