Provider Demographics
NPI:1033296587
Name:RABBANI, OMID (MD)
Entity Type:Individual
Prefix:DR
First Name:OMID
Middle Name:
Last Name:RABBANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 JONES WAY STE 30
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1221
Mailing Address - Country:US
Mailing Address - Phone:310-467-2815
Mailing Address - Fax:
Practice Address - Street 1:2650 JONES WAY
Practice Address - Street 2:30
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1221
Practice Address - Country:US
Practice Address - Phone:805-579-9999
Practice Address - Fax:805-579-9900
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 972402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology