# HAVASU CARDIAC SURGERY PC

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

## Provider details

- **NPI number:** 1679502470
- **Authorized official:** PIERRE R TIBI MD (OWNER)
- **Authorized official phone:** (602) 253-9168

## Contact information

- **Practice address:** 101 CIVIC CENTER LN, ATTN: HAVASU CARDIAC SURGERY, LAKE HAVASU CITY, AZ 86403-5607
- **Practice address phone:** (928) 854-0090
- **Practice address fax:** (928) 453-0671
- **Mailing address:** 3131 E CLARENDON AVE, SUITE 102, PHOENIX, AZ 85016-7069
- **Mailing address phone:** (602) 253-9168
- **Mailing address fax:** (602) 251-3126

## Taxonomy

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

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 03/10/2008