Healthcare Provider Details

I. General information

NPI: 1922337500
Provider Name (Legal Business Name): JASMINE OMRANI D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JASMINE ZARGARPOUR DO

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25965 S. NORMANDIE AVE.
HARBOR CITY CA
90710
US

IV. Provider business mailing address

3401 S HARBOR BLVD
SANTA ANA CA
92704-7933
US

V. Phone/Fax

Practice location:
  • Phone: 424-328-2313
  • Fax:
Mailing address:
  • Phone: 424-305-0573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A11O11
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: