MEDICARE: CARDIOVASCULAR ANESTHESIA CONSULTANTS

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1942344502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR ANESTHESIA CONSULTANTS

Provider Business Mailing Address
First Line	:	2850 S MOJOVE
Second Line	:	LOT A
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-1355
Country	:	US
Telephone Number	:	702-569-2319
Fax Number	:	702-562-8561

Provider Business Practice Location Address
First Line	:	2850 S MOJAVE RD LOT A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-1355
Country	:	US
Telephone Number	:	702-386-4700
Fax Number	:	702-386-4701

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	JOHN S SMITH
Credential	:	MD
Telephone Number	:	702-569-2319

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	02/13/2018

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