Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A9465 | CA |
N | 207Q00000X | Family Doctor | 20A9465 | CA |
Y | 207R00000X | Internist | 20A9465 | CA |
Y | 111NI0900X | Internist | 20A9465 | CA |
N | 207RA0401X | Internist - Addiction Medicine | 20A9465 | CA |
N | 208D00000X | General Practice Physician | 20A9465 | CA |
NPI | 1700945417 |
---|---|
Provider Name | Dr. Bahman Omrani |
First Address | Sherman Oaks, CA 91423-5515 |
Second Address | Sherman Oaks, CA 91423-5515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 10/05/2015 |