Healthcare Provider Details

I. General information

NPI: 1669635132
Provider Name (Legal Business Name): OMAR KRAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2008
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N HARBOR BLVD STE 100
FULLERTON CA
92835-4107
US

IV. Provider business mailing address

18 SUNSWEPT MESA
ALISO VIEJO CA
92656-8074
US

V. Phone/Fax

Practice location:
  • Phone: 714-879-0020
  • Fax: 714-526-2020
Mailing address:
  • Phone:
  • Fax: 530-237-1551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA116832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: