Provider Demographics
NPI:1346829603
Name:GHASSEMI, OMEED
Entity type:Individual
Prefix:
First Name:OMEED
Middle Name:
Last Name:GHASSEMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 WOODLAKE AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1470
Mailing Address - Country:US
Mailing Address - Phone:818-340-3822
Mailing Address - Fax:818-706-9857
Practice Address - Street 1:7320 WOODLAKE AVE STE 270
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1470
Practice Address - Country:US
Practice Address - Phone:818-340-3822
Practice Address - Fax:818-706-9857
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA200061208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics