Provider Demographics
NPI:1821001397
Name:IMBASCIANI, VITO (PHD, MD)
Entity Type:Individual
Prefix:DR
First Name:VITO
Middle Name:
Last Name:IMBASCIANI
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Gender:M
Credentials:PHD, MD
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Mailing Address - Street 1:6041 CADILLAC AVE
Mailing Address - Street 2:KAISER FOUNDATION HOSPITAL, DEPT. OF UROLOGY
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1702
Mailing Address - Country:US
Mailing Address - Phone:323-857-4198
Mailing Address - Fax:323-857-3891
Practice Address - Street 1:6041 CADILLAC AVE
Practice Address - Street 2:KAISER FOUNDATION HOSPITAL, DEPT. OF UROLOGY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1702
Practice Address - Country:US
Practice Address - Phone:323-857-4198
Practice Address - Fax:323-857-3891
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAG69863208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology