# SAM CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760014344
- **Authorized official:** DR. ANTONY N VANBANG MD (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (720) 666-5116

## Contact information

- **Practice address:** 1701 S FEDERAL BLVD, DENVER, CO 80219-4898
- **Practice address phone:** (720) 666-5116
- **Practice address fax:** (303) 934-4036
- **Mailing address:** 1701 S FEDERAL BLVD, DENVER, CO 80219-4898
- **Mailing address phone:** (720) 666-5116
- **Mailing address fax:** (303) 934-4036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/11/2020
- **Last updated:** 02/11/2020