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General NPI Number Information
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NPI Number | 1699298166
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Entity Type | Organization
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Legal Business Name | NIKA OMID, MD INC
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 4950 BARRANCA PKWY STE 111
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City | IRVINE
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State | CA
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Zip | 92604-4630
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Country | US
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Telephone | 949-652-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 4950 BARRANCA PKWY STE 111
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City | IRVINE
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State | CA
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Zip | 92604-4630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NIKA OMID
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Credential | MD
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Telephone | 858-663-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A100310
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License Number State | CA
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