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NPI Code Detail

MEDICARE: CARDIAC MOBILE DIAGNOSTICS LLC

MEDICARE: CARDIAC MOBILE DIAGNOSTICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12471S1302XSonography Radiologic Technologist
2261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1790540821
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDIAC MOBILE DIAGNOSTICS LLC
Provider Business Mailing Address
First Line : 6220 SILVER EDGE ST
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89031-3802
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6220 SILVER EDGE ST
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89031-3802
Country : US
Telephone Number : 702-612-0077
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BRIAN JOSEPH YANDOLINO
Credential :
Telephone Number : 702-612-0077
Provider Enumeration Date : 02/19/2024
Last Update Date : 02/19/2024

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Directions to “CARDIAC MOBILE DIAGNOSTICS LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.