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NPI Code Detail

MEDICARE: DR. OMAR J BASHIR D.O.

MEDICARE: DR. OMAR J BASHIR D.O.
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
1207R00000XInternal Medicine Physician20A8694CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891730479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OMAR J BASHIR D.O.
Provider Business Mailing Address
First Line : PO BOX 10069
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92423-0069
Country : US
Telephone Number : 909-335-4188
Fax Number :
Provider Business Practice Location Address
First Line : 5957 W RAMSEY ST
Second Line :
City : BANNING
State : CA
Zip : 92220-3058
Country : US
Telephone Number : 951-845-0313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 02/06/2020

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