Provider Demographics
NPI:1598872319
Name:KALIANGARA, OMANA THOMAS (NP)
Entity Type:Individual
Prefix:MS
First Name:OMANA
Middle Name:THOMAS
Last Name:KALIANGARA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:PHILOMENA
Other - Middle Name:THOMAS
Other - Last Name:KALIANGARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:3RD FLOOR - KAISER PERMANENTE
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:626-405-7914
Mailing Address - Fax:
Practice Address - Street 1:3033 BUNKER HILL ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-5705
Practice Address - Country:US
Practice Address - Phone:858-581-8086
Practice Address - Fax:858-581-8085
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN385098363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS51086Medicare UPIN