Provider Demographics
NPI:1164277661
Name:OMRANI, ALI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:OMRANI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 GLENFORD PARK CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-2015
Mailing Address - Country:US
Mailing Address - Phone:408-599-4121
Mailing Address - Fax:
Practice Address - Street 1:410 GLENFORD PARK CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-2015
Practice Address - Country:US
Practice Address - Phone:408-599-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty