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General NPI Number Information
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NPI Number | 1831532787
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Entity Type | Individual
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Provider Name | GLAREH IMANI D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 350 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85013-4409
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Country | US
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Telephone | 602-406-3837
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Fax |
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Provider Business Mailing Address
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Address Line | 530 E MCDOWELL RD # 107-470
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City | PHOENIX
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State | AZ
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Zip | 85004-1549
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Country | US
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Telephone | 469-237-0137
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 006884
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License Number State | AZ
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