Provider Demographics
NPI:1780115923
Name:AL KHAYRU, ALI (MBCHB)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:AL KHAYRU
Suffix:
Gender:
Credentials:MBCHB
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:ALKHAYRU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBCHB
Mailing Address - Street 1:2385 E PRATER WAY STE 302
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9638
Mailing Address - Country:US
Mailing Address - Phone:775-356-4514
Mailing Address - Fax:
Practice Address - Street 1:2385 E PRATER WAY STE 302
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9638
Practice Address - Country:US
Practice Address - Phone:775-356-4514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-47375207R00000X, 208M00000X
FLME150951207R00000X
NV27306207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist