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General NPI Number Information
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NPI Number | 1013495431
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Entity Type | Individual
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Provider Name | KAMRAN HUSSAIN IMAM MD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 3600 LIME ST STE 516
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City | RIVERSIDE
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State | CA
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Zip | 92501-0944
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Country | US
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Telephone | 951-367-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 8081 E SPRINGVIEW CT
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City | ANAHEIM
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State | CA
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Zip | 92808-1555
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Country | US
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Telephone | 909-342-4916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A173489
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | A173489
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | A173489
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License Number State | CA
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