Provider Demographics
NPI:1942344502
Name:CARDIOVASCULAR ANESTHESIA CONSULTANTS
Entity Type:Organization
Organization Name:CARDIOVASCULAR ANESTHESIA CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-569-2319
Mailing Address - Street 1:2850 S MOJOVE
Mailing Address - Street 2:LOT A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-1355
Mailing Address - Country:US
Mailing Address - Phone:702-569-2319
Mailing Address - Fax:702-562-8561
Practice Address - Street 1:2850 S MOJAVE RD LOT A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-1355
Practice Address - Country:US
Practice Address - Phone:702-386-4700
Practice Address - Fax:702-386-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWJBCLMedicare PIN