Provider Demographics
NPI:1700097847
Name:HAMIDI, HOMA (LAC)
Entity Type:Individual
Prefix:MS
First Name:HOMA
Middle Name:
Last Name:HAMIDI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22235 SHERMAN WAY
Mailing Address - Street 2:100
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1048
Mailing Address - Country:US
Mailing Address - Phone:818-888-8067
Mailing Address - Fax:818-702-6289
Practice Address - Street 1:22235 SHERMAN WAY
Practice Address - Street 2:100
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1048
Practice Address - Country:US
Practice Address - Phone:818-888-8067
Practice Address - Fax:818-702-6289
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8966171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist