Healthcare Provider Details

I. General information

NPI: 1265626584
Provider Name (Legal Business Name): DIAGNOSTIC INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 WYNN RD
LAS VEGAS NV
89103-5406
US

IV. Provider business mailing address

4880 WYNN RD
LAS VEGAS NV
89103-5406
US

V. Phone/Fax

Practice location:
  • Phone: 702-430-3815
  • Fax: 702-430-3816
Mailing address:
  • Phone: 702-430-3815
  • Fax: 702-430-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number1006578048
License Number StateNV

VIII. Authorized Official

Name: JON GREG GRIFFIN
Title or Position: PARTNER
Credential:
Phone: 702-430-3815