Healthcare Provider Details

I. General information

NPI: 1992115844
Provider Name (Legal Business Name): OMAR SAFI ZUBERI D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 S STATE ST STE 103
SOUTH SALT LAKE UT
84115-5096
US

IV. Provider business mailing address

PO BOX 412620
BOSTON MA
02241-2620
US

V. Phone/Fax

Practice location:
  • Phone: 801-281-0027
  • Fax: 801-262-1533
Mailing address:
  • Phone: 610-644-8900
  • Fax: 484-924-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberBP10068271
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR3970
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number13150965-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: