Healthcare Provider Details

I. General information

NPI: 1548042252
Provider Name (Legal Business Name): VALLEY IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 10/17/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 W SAHARA AVE # 3298
LAS VEGAS NV
89117-5858
US

IV. Provider business mailing address

1192 BEMBRIDGE DR
ROCHESTER HILLS MI
48307-5715
US

V. Phone/Fax

Practice location:
  • Phone: 248-690-6360
  • Fax:
Mailing address:
  • Phone: 248-690-6360
  • Fax: 844-437-6590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: ROMAN KOBITA
Title or Position: PRESIDENT
Credential:
Phone: 248-690-6360