Healthcare Provider Details

I. General information

NPI: 1780632539
Provider Name (Legal Business Name): SONORAN MRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7455 W WASHINGTON AVE SUITE 120
LAS VEGAS NV
89128-4337
US

IV. Provider business mailing address

7455 W WASHINGTON AVE # 120
LAS VEGAS NV
89128-4337
US

V. Phone/Fax

Practice location:
  • Phone: 702-804-6665
  • Fax: 702-804-6668
Mailing address:
  • Phone: 702-804-6665
  • Fax: 702-804-6668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SEAN MICHAEL ZAHNISER
Title or Position: OPERATING MANAGER
Credential:
Phone: 702-804-6665