Basic Information
Provider Information
NPI: 1598909160
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VASQUEZ
FirstName: JOSHUA
MiddleName: JORGE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13001 E 17TH PL
Address2:  
City: AURORA
State: CO
PostalCode: 800452559
CountryCode: US
TelephoneNumber: 3037246031
FaxNumber:  
Practice Location
Address1: 13001 E 17TH PL
Address2:  
City: AURORA
State: CO
PostalCode: 800452559
CountryCode: US
TelephoneNumber: 3037246031
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/28/2009
LastUpdateDate: 01/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LC0200X120084CAY Allopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine

No ID Information.


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