Provider Demographics
NPI:1740560861
Name:IBRAHIMI, SAID ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SAID
Middle Name:ALI
Last Name:IBRAHIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 BLACKHAWK PLAZA CIR STE 240
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4613
Mailing Address - Country:US
Mailing Address - Phone:925-648-2650
Mailing Address - Fax:925-648-2530
Practice Address - Street 1:4155 BLACKHAWK PLAZA CIR STE 240
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4613
Practice Address - Country:US
Practice Address - Phone:925-648-2650
Practice Address - Fax:925-648-2530
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-20
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1291712084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA129171OtherCA LICENSE
TXU1038OtherTX LICENSE
VA0101257588OtherVA LICENSE
AZ46087OtherAZ LICENSE
NY262206OtherNY LICENSE
NYXI2789141OtherSUBOXONE PROSCRIBER