Provider Demographics
NPI:1841229275
Name:EL-ATTAR, OSAMAH A (MD)
Entity Type:Individual
Prefix:DR
First Name:OSAMAH
Middle Name:A
Last Name:EL-ATTAR
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 1:1234 N VERMONT AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1704
Mailing Address - Country:US
Mailing Address - Phone:323-666-2727
Mailing Address - Fax:323-666-9056
Practice Address - Street 1:1234 N VERMONT AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1704
Practice Address - Country:US
Practice Address - Phone:323-666-2727
Practice Address - Fax:323-666-9056
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26314207R00000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A263140Medicaid
CA00A263141Medicaid
CAA83371Medicare UPIN
CA00A263140Medicaid
CAA26314Medicare ID - Type UnspecifiedCALIFORNIA MEDICARE ID