Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | ||
Y | 225XM0800X | Mental Health | 20755 | CA |
NPI | 1437708591 |
---|---|
Provider Name | Omar Arid |
First Address | Torrance, CA 90502-1029 |
Second Address | Torrance, CA 90502-1029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2019 |
Last Update Date | 23/12/2019 |