Individual
TAMI JESSICA BANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
1400 JACKSON ST, GRADUATE MEDICAL EDUCATION PROGRAM, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2174
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
55053
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL-3678
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63430771
—
CO
Enumeration date
06/21/2010
Last updated
07/21/2022
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