Healthcare Provider Details

I. General information

NPI: 1427915461
Provider Name (Legal Business Name): OMYMA NAQVI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W LA VETA AVE STE 220
ORANGE CA
92868-4446
US

IV. Provider business mailing address

8258 E BIRCH TREE LN
ANAHEIM CA
92808-2321
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA67462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: