Individual
OMAR MIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(209) 468-6600
(209) 468-7042
Mailing address
PO BOX 1020, STOCKTON, CA 95201-3120
(209) 468-6600
(209) 468-7042
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A101057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A101057
MEDICAL LICENSE
CA
Enumeration date
06/18/2008
Last updated
12/15/2021
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