Individual
DR. TONY SANGCHOMPUPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2045 N FRANKLIN ST, DENVER, CO 80205-5437
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2006002250
MO
2085R0202X
Diagnostic Radiology Physician
35081743
OH
2085R0202X
Diagnostic Radiology Physician
Primary
47326
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019469
KAISER COMMERCIAL NUMBER
CO
05
—
2401056
—
OH
05
—
26457733
—
CO
01
—
300136030
SOR RR MDCR PIN NUMBER
OH
05
—
64063977
—
KY
01
—
P00202433
SOM RR MDCR PIN NUMBER
OH
Enumeration date
07/22/2005
Last updated
04/20/2021
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