Provider Demographics
NPI:1043236102
Name:WEST VALLEY IMAGING LIMITED
Entity Type:Organization
Organization Name:WEST VALLEY IMAGING LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST/MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-222-3544
Mailing Address - Street 1:3025 S RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6582
Mailing Address - Country:US
Mailing Address - Phone:702-222-3544
Mailing Address - Fax:702-889-0422
Practice Address - Street 1:3025 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6582
Practice Address - Country:US
Practice Address - Phone:702-222-3544
Practice Address - Fax:702-889-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV64532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2019306Medicaid
NVD43721Medicare UPIN
NV2019306Medicaid