Provider Demographics
NPI:1447387725
Name:CARDIOVASCULAR SURGERY ASSOCIATES
Entity type:Organization
Organization Name:CARDIOVASCULAR SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIP
Authorized Official - Middle Name:
Authorized Official - Last Name:RATTIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-614-6550
Mailing Address - Street 1:1090 E DESERT INN RD
Mailing Address - Street 2:#202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2824
Mailing Address - Country:US
Mailing Address - Phone:702-614-6550
Mailing Address - Fax:702-614-6562
Practice Address - Street 1:1090 E DESERT INN RD
Practice Address - Street 2:#202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2824
Practice Address - Country:US
Practice Address - Phone:702-614-6550
Practice Address - Fax:702-614-6562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV70126208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC03140OtherRAILROAD MEDICARE PROVIDE
NV=========89109A001OtherTRICARE PROVIDER #
NV=========89109A001OtherTRICARE PROVIDER #