Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 24947 | WI |
N | 111NI0900X | Internist | 24947 | WI |
Y | 207R00000X | Internist | G42323 | CA |
Y | 111NI0900X | Internist | G42323 | CA |
NPI | 1003244518 |
---|---|
Provider Name | Dr. Wayne Imber |
First Address | Calabasas, CA 91302 |
Second Address | Calabasas, CA 91302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2013 |
Last Update Date | 18/10/2013 |