Healthcare Provider Details

I. General information

NPI: 1952833667
Provider Name (Legal Business Name): OMAR RAHMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 NEILSON WAY UNIT 403
SANTA MONICA CA
90405-5369
US

IV. Provider business mailing address

2920 NEILSON WAY UNIT 403
SANTA MONICA CA
90405-5369
US

V. Phone/Fax

Practice location:
  • Phone: 412-849-9462
  • Fax:
Mailing address:
  • Phone: 412-849-9462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA176100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: