Provider Demographics
NPI:1386632065
Name:SEWANI, HASSANALI (MD)
Entity Type:Individual
Prefix:
First Name:HASSANALI
Middle Name:
Last Name:SEWANI
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 1:2809 CRYSTAL BEACH DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-6908
Mailing Address - Country:US
Mailing Address - Phone:702-492-0525
Mailing Address - Fax:702-492-0525
Practice Address - Street 1:2809 CRYSTAL BEACH DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-6908
Practice Address - Country:US
Practice Address - Phone:702-655-1400
Practice Address - Fax:702-685-0612
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10241207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018814Medicaid
CAXPY202385OtherMEDI CAL
G96900Medicare UPIN