Provider Demographics
NPI:1104876416
Name:ROHANI, ARDESHIR (MD)
Entity type:Individual
Prefix:
First Name:ARDESHIR
Middle Name:
Last Name:ROHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7633 BELMONDO LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7814
Mailing Address - Country:US
Mailing Address - Phone:702-463-3000
Mailing Address - Fax:702-463-3001
Practice Address - Street 1:3824 S JONES BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2451
Practice Address - Country:US
Practice Address - Phone:702-463-3000
Practice Address - Fax:702-463-3001
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9011207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018250Medicaid
NVH09657Medicare UPIN
NV002018250Medicaid