MEDICARE: BIBI OMAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036122160	IL
2	207Q00000X	Family Medicine Physician	15960	NV

General Provider Information

NPI Number	:	1275755001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIBI OMAR M.D.

Provider Business Mailing Address
First Line	:	1800 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2386
Country	:	US
Telephone Number	:	702-383-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5860 LOSEE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6595
Country	:	US
Telephone Number	:	702-383-3910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	12/19/2024

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