Healthcare Provider Details

I. General information

NPI: 1467362947
Provider Name (Legal Business Name): SEAN OMAHONY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8382 NEWMAN AVE
HUNTINGTON BEACH CA
92647-7095
US

IV. Provider business mailing address

4550 MONTAIR AVE APT 27
LONG BEACH CA
90808-1251
US

V. Phone/Fax

Practice location:
  • Phone: 714-842-5551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT308031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: