Provider Demographics
NPI:1417691064
Name:VIAN, CHILALI DANIT (RDMS, RVT)
Entity Type:Individual
Prefix:
First Name:CHILALI
Middle Name:DANIT
Last Name:VIAN
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 INSPIRATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5611
Mailing Address - Country:US
Mailing Address - Phone:928-275-2588
Mailing Address - Fax:
Practice Address - Street 1:415 INSPIRATIONAL DR
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5611
Practice Address - Country:US
Practice Address - Phone:928-275-2588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1563582471S1302X, 2085U0001X
AZ1563582471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound