Basic Information
| Provider Information | |||||||||
| NPI: | 1356855126 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IMAGING ASSOCIATES OF NEVADA, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 MACARTHUR PL STE 300 | ||||||||
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| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927077726 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4855 BLUE DIAMOND RD | ||||||||
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| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891397602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134613573 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | SCANLON | ||||||||
| AuthorizedOfficialFirstName: | KEEGAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ENROLLMENT OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4243548724 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.