Provider Demographics
NPI:1386656866
Name:SADOUGHIAN, ALI A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:A
Last Name:SADOUGHIAN
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 1:2202 BLACKBURN HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0159
Mailing Address - Country:US
Mailing Address - Phone:702-804-4162
Mailing Address - Fax:
Practice Address - Street 1:630 S RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4873
Practice Address - Country:US
Practice Address - Phone:702-636-6355
Practice Address - Fax:702-636-4008
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18767207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease