MEDICARE: VIVA DIAGNOSTIC IMAGING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1659220168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIVA DIAGNOSTIC IMAGING, LLC

Provider Business Mailing Address
First Line	:	7175 N DURANGO DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4486
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7175 N DURANGO DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4486
Country	:	US
Telephone Number	:	702-941-7512
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BRADFORD AMES
Credential	:
Telephone Number	:	949-490-5538

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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