Healthcare Provider Details

I. General information

NPI: 1962091926
Provider Name (Legal Business Name): US DIAGNOSTIC LV MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 E FLAMINGO RD STE 15B
LAS VEGAS NV
89119-5276
US

IV. Provider business mailing address

1600 E DESERT INN RD STE 220
LAS VEGAS NV
89169-2505
US

V. Phone/Fax

Practice location:
  • Phone: 725-735-4042
  • Fax: 747-477-1182
Mailing address:
  • Phone: 747-477-1064
  • Fax: 747-477-1182

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: MARINA AGASYAN
Title or Position: CEO
Credential:
Phone: 725-735-4042