| Big Tree Medical Group Llc | |
|
1701 S Federal Blvd Denver CO 80219-4898 | |
| (720) 323-0621 | |
| (303) 934-4036 |
| Full Name | Big Tree Medical Group Llc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1701 S Federal Blvd, Denver, Colorado |
| Authorized Official Name and Position | Antony Nguyen Vanbang (PRIMARY PROVIDER) |
| Authorized Official Contact | 7203230621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Tree Medical Group Llc 1701 S Federal Blvd Denver CO 80219-4898 Ph: (720) 323-0621 | Big Tree Medical Group Llc 1701 S Federal Blvd Denver CO 80219-4898 Ph: (720) 323-0621 |
| NPI Number | 1063167211 |
|---|---|
| Provider Enumeration Date | 02/16/2022 |
| Last Update Date | 03/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063167211 | NPI | - | NPPES |
| DR.0054747 | Other | CO | COLORADO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS AND OCCUPATIO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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