Provider Demographics
NPI:1174716583
Name:IBRAHIMI, WAHEED SAID (MD)
Entity type:Individual
Prefix:
First Name:WAHEED
Middle Name:SAID
Last Name:IBRAHIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4847 HOPYARD RD
Mailing Address - Street 2:SUITE 4411
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3360
Mailing Address - Country:US
Mailing Address - Phone:510-512-0533
Mailing Address - Fax:
Practice Address - Street 1:1081 MARKET PL STE 500
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4750
Practice Address - Country:US
Practice Address - Phone:925-365-7337
Practice Address - Fax:925-522-4372
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42035207R00000X
CAA128575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ453891Medicaid
AZZ147410Medicare PIN
AZZ145417Medicare PIN