Individual
DELARAM DEVORAH OMIDFAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6243 TAMPA AVE, TARZANA, CA 91335-6644
(818) 602-8512
Mailing address
6243 TAMPA AVE, TARZANA, CA 91335-6644
(818) 602-8512
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
95089153
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95031576
CA
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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