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Individual
OMID KHODADADI
Active
Individual
OMID KHODADADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A101046
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01497136
RAILROAD PTAN
CA
Enumeration date
03/18/2008
Last updated
10/26/2015
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