Provider Demographics
NPI:1780632539
Name:SONORAN MRI LLC
Entity Type:Organization
Organization Name:SONORAN MRI LLC
Other - Org Name:SONORAN MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZAHNISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-804-6665
Mailing Address - Street 1:7455 W WASHINGTON AVE
Mailing Address - Street 2:# 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4337
Mailing Address - Country:US
Mailing Address - Phone:702-804-6665
Mailing Address - Fax:702-804-6668
Practice Address - Street 1:7455 W WASHINGTON AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4337
Practice Address - Country:US
Practice Address - Phone:702-804-6665
Practice Address - Fax:702-804-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511021Medicaid