Healthcare Provider Details

I. General information

NPI: 1114305638
Provider Name (Legal Business Name): IMRAN AHMED SAYEEDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2015
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18399 VENTURA BLVD STE 245
TARZANA CA
91356
US

IV. Provider business mailing address

1565 SILVER SHADOW DR
NEWBURY PARK CA
91320-3525
US

V. Phone/Fax

Practice location:
  • Phone: 818-609-7536
  • Fax:
Mailing address:
  • Phone: 818-309-9462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA157829
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA157829
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA157829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: