Provider Demographics
NPI:1851762702
Name:SACHS, TAMARA DANIELSON (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:TAMARA
Middle Name:DANIELSON
Last Name:SACHS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-563-2755
Mailing Address - Fax:303-861-6219
Practice Address - Street 1:1601 E 19TH AVE STE 3800
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1252
Practice Address - Country:US
Practice Address - Phone:303-563-2755
Practice Address - Fax:303-861-6219
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CO4743363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09175059Medicaid
CO09175059Medicaid