Healthcare Provider Details

I. General information

NPI: 1700945417
Provider Name (Legal Business Name): BAHMAN OMRANI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 05/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 WOODMAN AVE STE 101
SHERMAN OAKS CA
91423-5515
US

IV. Provider business mailing address

4312 WOODMAN AVE STE 101
SHERMAN OAKS CA
91423-5515
US

V. Phone/Fax

Practice location:
  • Phone: 818-988-4088
  • Fax:
Mailing address:
  • Phone: 818-988-4088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number20A9465
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A9465
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A9465
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number20A9465
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number20A9465
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number20A9465
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20A9465
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A9465
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number20A9465
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number20A9465
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number20A9465
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: