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NPI Code Detail

MEDICARE: CARDIOVASCULAR SURGERY ASSOCIATES

MEDICARE: CARDIOVASCULAR SURGERY ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician70126NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C03140OTHERNVRAILROAD MEDICARE PROVIDE

General Provider Information

NPI Number : 1447387725
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDIOVASCULAR SURGERY ASSOCIATES
Provider Business Mailing Address
First Line : 1090 E DESERT INN RD
Second Line : #202
City : LAS VEGAS
State : NV
Zip : 89109-2824
Country : US
Telephone Number : 702-614-6550
Fax Number : 702-614-6562
Provider Business Practice Location Address
First Line : 1090 E DESERT INN RD
Second Line : #202
City : LAS VEGAS
State : NV
Zip : 89109-2824
Country : US
Telephone Number : 702-614-6550
Fax Number : 702-614-6562
Authorized Official
Title or Position : ADMINISTRATOR
Name : CHIP RATTIGAN
Credential :
Telephone Number : 702-614-6550
Provider Enumeration Date : 02/27/2007
Last Update Date : 08/22/2020

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