Provider Demographics
NPI:1952374464
Name:MADANI, ALI ALAIN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:ALAIN
Last Name:MADANI
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:MADANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:
Practice Address - Street 1:2650 N TENAYA WAY STE 201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1110
Practice Address - Country:US
Practice Address - Phone:702-735-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070143207RH0003X
NV27176207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860938204OtherTAX ID
NV1952374464Medicaid
AZ076877Medicaid
NV27176OtherSTATE LICENSE