Organization
JAHAN IMANI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAHAN IMANI MD (LEAD PHYSICIAN)
(801) 475-7707
Entity
Organization
Contact information
Practice address
5315 ADAMS AVE PKWY, SUITE A, WASHINGTON TERRACE, UT 84405-4766
(801) 475-5950
(801) 475-7322
Mailing address
P.O. BOX 9519, OGDEN, UT 84409
(801) 475-7707
(801) 475-7322
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2606151205
UT
174400000X
Specialist
51777271205
UT
174400000X
Specialist
57891911205
UT
174400000X
Specialist
58040891205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000057660
GOUP MEDICARE NUMBER
UT
05
—
3010760
—
UT
Enumeration date
03/27/2007
Last updated
05/13/2019
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