Provider Demographics
NPI:1497087290
Name:ROBERT IMANI MD, INC.
Entity Type:Organization
Organization Name:ROBERT IMANI MD, INC.
Other - Org Name:ROBERT IMANI, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BABAK
Authorized Official - Last Name:IMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-571-5576
Mailing Address - Street 1:1505 W AVENUE J
Mailing Address - Street 2:103
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2843
Mailing Address - Country:US
Mailing Address - Phone:818-571-5576
Mailing Address - Fax:
Practice Address - Street 1:1505 W AVENUE J
Practice Address - Street 2:103
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2843
Practice Address - Country:US
Practice Address - Phone:818-571-5576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty