# HAVASU CARDIAC SURGERY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063811859
- **Authorized official:** PANKAJ KULSHRESTHA M.D. (OWNER/MEMBER)
- **Authorized official phone:** (917) 536-6453

## Contact information

- **Practice address:** 1741 MESQUITE AVE, STE. A200, LAKE HAVASU CITY, AZ 86403-5695
- **Practice address phone:** (917) 536-6453
- **Practice address fax:** (888) 491-7482
- **Mailing address:** PO BOX 707, LAKE HAVASU CITY, AZ 86405-0707
- **Mailing address phone:** (917) 536-6453
- **Mailing address fax:** (888) 491-7482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 36397 | AZ | Yes |

## Other

- **Enumeration date:** 08/18/2014
- **Last updated:** 02/22/2017