Healthcare Provider Details

I. General information

NPI: 1710155163
Provider Name (Legal Business Name): DEVANGI D DESAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 S MCCARRAN BLVD STE 9
RENO NV
89509-6189
US

IV. Provider business mailing address

5975 S LOS ALTOS PKWY
SPARKS NV
89436-7699
US

V. Phone/Fax

Practice location:
  • Phone: 775-204-4000
  • Fax: 775-234-4605
Mailing address:
  • Phone: 775-204-4000
  • Fax: 775-234-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12906
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301084322
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12906
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301084322
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: