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General NPI Number Information
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NPI Number | 1730613019
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Entity Type | Individual
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Provider Name | IMAN FOBIA
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Gender | Female
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 2139 GEORGIA AVE NW FL 2
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City | WASHINGTON
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State | DC
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Zip | 20059-1029
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Country | US
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Telephone | 202-806-9028
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Fax |
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Provider Business Mailing Address
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Address Line | 2139 GEORGIA AVE NW FL 2
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City | WASHINGTON
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State | DC
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Zip | 20059-1029
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Country | US
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Telephone | 202-806-9028
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A161943
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD210002929
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License Number State | DC
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