Individual
OMAR IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40910 FREMONT BLVD, FREMONT, CA 94538-4375
(510) 770-8040
Mailing address
40910 FREMONT BLVD, FREMONT, CA 94538-4375
(510) 770-8040
(510) 770-8141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA64594
CA
363AM0700X
Medical Physician Assistant
Primary
PA64594
CA
Other
Enumeration date
02/19/2024
Last updated
04/08/2026
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