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General NPI Number Information
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NPI Number | 1265616429
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Entity Type | Organization
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Legal Business Name | OMAR TIRMIZI, MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 9808 VENICE BLVD SUITE 404
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City | CULVER CITY
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State | CA
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Zip | 90232-2732
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Country | US
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Telephone | 310-556-0702
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Fax | 310-556-8464
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Provider Business Mailing Address
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Address Line | 9808 VENICE BLVD SUITE 404
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City | CULVER CITY
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State | CA
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Zip | 90232-2732
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Country | US
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Telephone | 310-556-0702
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Fax | 310-556-8464
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | OMAR TRIMIZI
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Credential | MD
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Telephone | 310-556-0702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A53175
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | A53175
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A53175
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License Number State | CA
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