Individual
DR. OMAR M FARIDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N STATE ST, CT A3C 117, LOS ANGELES, CA 90033-1029
(323) 409-5051
Mailing address
947 CRYSTAL WATER LN, WALNUT, CA 91789-1467
(909) 839-3509
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
A107924
CA
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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