Provider Demographics
NPI:1629137427
Name:OMAR, AKBAR (MD)
Entity Type:Individual
Prefix:
First Name:AKBAR
Middle Name:
Last Name:OMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 N SUNSET AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2278
Mailing Address - Country:US
Mailing Address - Phone:626-338-7359
Mailing Address - Fax:626-960-3932
Practice Address - Street 1:222 N SUNSET AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2278
Practice Address - Country:US
Practice Address - Phone:626-338-7359
Practice Address - Fax:626-960-3932
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA32838174400000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC35409Medicare UPIN