Individual provider · Type 1 NPI

Todd A. Radivan, PA-C

Medical Physician Assistant · Las Vegas, NV

NPI number 1497757181 Active

Practice location

888 S Rancho Dr
Las Vegas, NV 89106-3810

Call (702) 877-8600 Map

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA2007 (NV)
Medical Physician Assistant Primary 363AM0700XPA2007 (NV)

Medical Physician Assistant: Definition to come...

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About NPI 1497757181

Todd A. Radivan, PA-C's National Provider Identifier is 1497757181, issued on Aug 11, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Las Vegas, NV. The record was last updated on May 28, 2026.