Provider Demographics
NPI:1619204054
Name:OMEGA CHOICE INC
Entity Type:Organization
Organization Name:OMEGA CHOICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-498-6901
Mailing Address - Street 1:419 N LARCHMONT BLVD
Mailing Address - Street 2:#73
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-3013
Mailing Address - Country:US
Mailing Address - Phone:310-498-6901
Mailing Address - Fax:
Practice Address - Street 1:436 N BEDFORD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4310
Practice Address - Country:US
Practice Address - Phone:310-498-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty