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Organization
TALIB OMER MD PC
Active
Organization
TALIB OMER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA MERRITT (SENIOR MANAGER, CREDENTIALING)
(813) 596-5726
Entity
Organization
Contact information
Practice address
3415 S SEPULVEDA BLVD FL 10, LOS ANGELES, CA 90034-6060
(888) 878-4256
Mailing address
3865 HOLCOMB BRIDGE RD, PEACHTREE CORNERS, GA 30092-2205
(888) 878-4256
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
03/01/2022
Last updated
01/15/2024
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