Radivan, Todd A

Radivan, Todd A is an individual health care provider with primary practice located at 888 S Rancho Dr , Las Vegas NV 89106-3810. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Radivan, Todd A can be contacted via phone (702) 877-8600.

Contact Information

Primary practice address
888 S Rancho Dr Las Vegas NV 89106-3810
Phone: (702) 877-8600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2007 Nevada
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2007 Nevada

Profile Details

NPI number 1497757181
LBN Legal business name Radivan, Todd A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated May 28th, 2026 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497757181 NPPES
Nevada Other V110823 SMA MEDICARE
Nevada Other 1497757181 SMA MEDICARE

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