Basic Information
Provider Information
NPI: 1093246423
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAKAMOTO
FirstName: MANDY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5200 DTC PKWY STE 400
Address2:  
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801112719
CountryCode: US
TelephoneNumber: 3037450000
FaxNumber: 3037733101
Practice Location
Address1: 5200 DTC PKWY STE 400
Address2:  
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801112719
CountryCode: US
TelephoneNumber: 3037450000
FaxNumber: 3037733101
Other Information
ProviderEnumerationDate: 03/27/2017
LastUpdateDate: 08/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0063955CON Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X0063955COY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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