MEDICARE: NILY OSMAN MD

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	261QM2500X	Medical Specialty Clinic/Center	A195420	CA

General Provider Information

NPI Number	:	1831944834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NILY OSMAN MD

Provider Business Mailing Address
First Line	:	2811 WILSHIRE BLVD STE 790
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4805
Country	:	US
Telephone Number	:	310-453-6005
Fax Number	:	310-829-1389

Provider Business Practice Location Address
First Line	:	2811 WILSHIRE BLVD STE 790
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4805
Country	:	US
Telephone Number	:	310-453-6005
Fax Number	:	310-829-1389

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

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	04/22/2024

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