Provider Demographics
NPI:1336144872
Name:OSKOOILAR, NADER (MD)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:
Last Name:OSKOOILAR
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 1:1601 DOVE ST
Mailing Address - Street 2:290
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2433
Mailing Address - Country:US
Mailing Address - Phone:949-244-7518
Mailing Address - Fax:
Practice Address - Street 1:1601 DOVE ST
Practice Address - Street 2:290
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2433
Practice Address - Country:US
Practice Address - Phone:949-244-7518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA483692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A483690Medicare ID - Type Unspecified
CAF01559Medicare UPIN