MEDICARE: MR. MUHAMMAD OMAR ABOU-HARB HEALTH CARE 39020000

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	548768	CA

General Provider Information

NPI Number	:	1598936106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MUHAMMAD OMAR ABOU-HARB HEALTH CARE 39020000

Provider Business Mailing Address
First Line	:	3400 DOW AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-1511
Country	:	US
Telephone Number	:	310-933-2059
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 DOW AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-1511
Country	:	US
Telephone Number	:	310-933-2059
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2008
Last Update Date	:	06/14/2024

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