Individual
MR. OMAR COLTRANE STAPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5709 MARKET ST, OAKLAND, CA 94608-2811
(510) 444-9460
(510) 444-1966
Mailing address
5709 MARKET ST, OAKLAND, CA 94608-2811
(510) 444-9460
(510) 444-1966
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16192
CA
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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