Provider Demographics
NPI:1538321369
Name:CARDIOVASCULAR CONSULTANTS, LTD
Entity Type:Organization
Organization Name:CARDIOVASCULAR CONSULTANTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-867-8644
Mailing Address - Street 1:PO BOX 98819
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193
Mailing Address - Country:US
Mailing Address - Phone:602-494-3659
Mailing Address - Fax:602-867-3862
Practice Address - Street 1:5422 W. THUNDERBIRD
Practice Address - Street 2:SUITE 8
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306
Practice Address - Country:US
Practice Address - Phone:602-978-0698
Practice Address - Fax:602-978-5958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site