Healthcare Provider Details

I. General information

NPI: 1932737749
Provider Name (Legal Business Name): HAVAL ALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST
RENO NV
89502-1576
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-4545
  • Fax: 775-982-4546
Mailing address:
  • Phone: 775-982-4545
  • Fax: 775-982-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number27361
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: