# MODERN VASCULAR OF DENVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184279804
- **Authorized official:** YURY GAMPEL (MANAGER)
- **Authorized official phone:** (818) 880-8605

## Contact information

- **Practice address:** 9441 HURON ST, THORNTON, CO 80260-5426
- **Practice address phone:** (720) 617-7333
- **Practice address fax:** (720) 627-8845
- **Mailing address:** 26500 AGOURA RD STE 201, CALABASAS, CA 91302-3556
- **Mailing address phone:** (818) 880-8605
- **Mailing address fax:** (818) 579-7916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2471V0106X | Vascular-Interventional Technology Radiologic Technologist | — | NULL | — |
| 2471V0106X | Vascular-Interventional Technology Radiologic Technologist | — | — | — |

## Other

- **Enumeration date:** 08/08/2019
- **Last updated:** 01/10/2020