Provider Demographics
NPI:1902853765
Name:COLORADO AMBULATORY ANESTHESIA SPECIALISTS
Entity Type:Organization
Organization Name:COLORADO AMBULATORY ANESTHESIA SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAMAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DORIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-422-9438
Mailing Address - Street 1:1819 DENVER WEST DR
Mailing Address - Street 2:BLDG 26 STE 200
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3118
Mailing Address - Country:US
Mailing Address - Phone:303-422-9438
Mailing Address - Fax:303-422-9474
Practice Address - Street 1:1819 DENVER WEST DR
Practice Address - Street 2:BLDG 26 STE 200
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3118
Practice Address - Country:US
Practice Address - Phone:303-422-9438
Practice Address - Fax:303-422-9474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2007-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08305587Medicaid
COC805544Medicare PIN