Provider Demographics
NPI:1174814594
Name:AMANI, PEDRAM E (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRAM
Middle Name:E
Last Name:AMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:14747 N NORTHSIGHT BLVD
Mailing Address - Street 2:SUITE 111-200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14747 N NORTHSIGHT BLVD
Practice Address - Street 2:SUITE 111-200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2631
Practice Address - Country:US
Practice Address - Phone:760-587-9558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ508412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry