Individual
DR. OMAR KHOLAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
2080 CENTURY PARK E STE 610, LOS ANGELES, CA 90067-2009
(424) 209-4190
Mailing address
3863 SKY VIEW LN, GLENDALE, CA 91214-1006
(818) 469-9502
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
102062
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2016
Last updated
06/25/2022
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