Healthcare Provider Details

I. General information

NPI: 1588824411
Provider Name (Legal Business Name): SONO IMAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3017 W CHARLESTON BLVD STE 90
LAS VEGAS NV
89102-1928
US

IV. Provider business mailing address

6380 NARROW ISTHMUS AVE
LAS VEGAS NV
89139-6411
US

V. Phone/Fax

Practice location:
  • Phone: 702-460-1941
  • Fax:
Mailing address:
  • Phone: 702-460-1941
  • Fax: 702-252-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number2000091-320
License Number StateNV

VIII. Authorized Official

Name: NAIRA BAGDASARIAN
Title or Position: OWNER
Credential: RDMS, RVT, RDCS
Phone: 702-460-1941