Provider Demographics
NPI:1598936106
Name:ABOU-HARB, MUHAMMAD OMAR (HEALTH CARE 39020000)
Entity Type:Individual
Prefix:MR
First Name:MUHAMMAD
Middle Name:OMAR
Last Name:ABOU-HARB
Suffix:
Gender:M
Credentials:HEALTH CARE 39020000
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DOW AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-1511
Mailing Address - Country:US
Mailing Address - Phone:310-933-2059
Mailing Address - Fax:
Practice Address - Street 1:3400 DOW AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-1511
Practice Address - Country:US
Practice Address - Phone:310-933-2059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-23
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA548768390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program