Organization
PHAN TACS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER PHAN MD (SOLE MEMBER)
(720) 471-8710
Entity
Organization
Contact information
Practice address
10103 RIDGEGATE PKWY STE 207, LONE TREE, CO 80124-5525
(720) 471-8710
Mailing address
10103 RIDGEGATE PKWY STE 207, LONE TREE, CO 80124-5525
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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