Provider Demographics
NPI:1598515199
Name:JAVAID, IMRAN
Entity Type:Individual
Prefix:
First Name:IMRAN
Middle Name:
Last Name:JAVAID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 EAST RD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8146
Mailing Address - Country:US
Mailing Address - Phone:626-347-7070
Mailing Address - Fax:
Practice Address - Street 1:11500 BROOKSHIRE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4917
Practice Address - Country:US
Practice Address - Phone:626-347-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program