Organization
PHYSICIAN ASSOCIATES OF NEVADA LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD RADIVAN PA-C (MANAGING DIRECTOR)
(702) 307-5522
Entity
Organization
Contact information
Practice address
2900 W HORIZON RIDGE PKWY STE 100, HENDERSON, NV 89052-5014
(702) 307-5522
(702) 991-7258
Mailing address
2900 W HORIZON RIDGE PKWY STE 100, HENDERSON, NV 89052-5014
(702) 307-5522
(702) 991-7258
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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