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Organization
KEIICHIRO OMORI MD
Active
Organization
KEIICHIRO OMORI MD
Active
Other names
KEIICHIRO OMORI MD
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
1801 W ROMNEYA DR STE 407, ANAHEIM, CA 92801-1827
(714) 533-3870
(714) 533-6714
Mailing address
1801 W ROMNEYA DR STE 407, ANAHEIM, CA 92801-1827
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A26248
CA
Other
Enumeration date
10/23/2006
Last updated
08/22/2020
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