Individual
OM PRAKASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
18056 WIKA RD, SUITE B, APPLE VALLEY, CA 92307-2125
(760) 242-2223
(760) 242-1293
Mailing address
18056 WIKA RD, SUITE B, APPLE VALLEY, CA 92307-2125
(760) 242-2223
(760) 242-1293
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A39024
CA
207VX0000X
Obstetrics Physician
Primary
A39024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A390240
—
CA
Enumeration date
02/03/2006
Last updated
01/25/2024
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