Provider Demographics
NPI:1669635132
Name:KRAD, OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:KRAD
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 1:8214 CITY LIGHTS DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:708-829-3542
Mailing Address - Fax:
Practice Address - Street 1:27871 MEDICAL CENTER ROAD
Practice Address - Street 2:SUITE 120
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-6688
Practice Address - Fax:949-364-6689
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-05
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116832207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology