MEDICARE: TENAYA CARDIOVASCULAR (GABASHA) PLLC

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
1	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1538974233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENAYA CARDIOVASCULAR (GABASHA) PLLC

Provider Business Mailing Address
First Line	:	410 S RAMPART BLVD STE 350
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5730
Country	:	US
Telephone Number	:	702-366-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 S RAMPART BLVD STE 350
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5730
Country	:	US
Telephone Number	:	702-366-6000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEFFREY LEVISMAN
Credential	:
Telephone Number	:	310-927-6910

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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