Provider Demographics
NPI:1205087038
Name:MASRI, VANSTON O (DO)
Entity type:Individual
Prefix:DR
First Name:VANSTON
Middle Name:O
Last Name:MASRI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E 19TH AVE STE 3600
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:844-443-3968
Practice Address - Street 1:1601 E 19TH AVE STE 3600
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1252
Practice Address - Country:US
Practice Address - Phone:720-515-2353
Practice Address - Fax:844-443-3968
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH39.009748390200000X
CO0054513207L00000X
COTL2872390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO026606OtherKAISER COMMERCIAL NUMBER
CO66107075Medicaid
CO417808YK5YMedicare PIN