Most Relevant Information
Provider Data
| NPI Number: | 1003302662 |
| Provider Name: | OMAR A MEDINA |
| Entity Type: | Individual |
| Taxonomy Code: | 2355S0801X |
| Specialty: | Specialist/Technologist |
| License Number: | 4213 |
Most Important Dates
| Enumeration Date: | 07/06/2018 |
| Last Updated: | 07/06/2018 |
Provider Practice Location
12411 SLAUSON AVE STE H
WHITTIER
CA
906062835
Practice Location Phone/Fax
| Phone: | 5626935449 |
| Fax: |
Provider Mailing Location
666 BRADSHAWE AVE
LOS ANGELES
CA
900223403
Provider Mailing Phone/Fax
| Phone: | 9095425204 |
| Fax: |