Provider Demographics
NPI:1538207956
Name:YUMA CARDIAC SURGERY PLC
Entity type:Organization
Organization Name:YUMA CARDIAC SURGERY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-341-1981
Mailing Address - Street 1:1501 W 24TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6370
Mailing Address - Country:US
Mailing Address - Phone:928-341-1981
Mailing Address - Fax:928-341-1984
Practice Address - Street 1:1501 W 24TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6370
Practice Address - Country:US
Practice Address - Phone:928-341-1981
Practice Address - Fax:928-341-1984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34827208G00000X
AZ17167208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ995417Medicaid
AZ191635Medicaid
AZ100277Medicare ID - Type Unspecified
AZ995417Medicaid
AZA53621Medicare UPIN
AZ191635Medicaid