MEDICARE: DR. TASNEEM BADER-OMARALI 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	207R00000X	Internal Medicine Physician	G85053	CA

General Provider Information

NPI Number	:	1578658795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TASNEEM BADER-OMARALI M.D.

Provider Business Mailing Address
First Line	:	2324 SANTA RITA ROAD #11
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94566
Country	:	US
Telephone Number	:	925-417-7505
Fax Number	:

Provider Business Practice Location Address
First Line	:	5924 STONERIDGE DR STE 103
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-5400
Country	:	US
Telephone Number	:	925-417-7505
Fax Number	:

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	11/17/2022

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