Healthcare Provider Details

I. General information

NPI: 1851762702
Provider Name (Legal Business Name): TAMARA DANIELSON SACHS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE STE 3800
DENVER CO
80218-1252
US

IV. Provider business mailing address

4900 S MONACO ST STE 210
DENVER CO
80237-3487
US

V. Phone/Fax

Practice location:
  • Phone: 303-563-2755
  • Fax: 303-861-6219
Mailing address:
  • Phone: 303-563-2755
  • Fax: 303-861-6219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4743
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: