Provider Demographics
NPI:1396242368
Name:GHAFFARIAN, AMIR ALI (MD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:ALI
Last Name:GHAFFARIAN
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 1:8930 W SUNSET RD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5008
Mailing Address - Country:US
Mailing Address - Phone:801-702-7023
Mailing Address - Fax:
Practice Address - Street 1:8930 W SUNSET RD STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5008
Practice Address - Country:US
Practice Address - Phone:801-702-7023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV239152086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery