Provider Demographics
NPI:1538975230
Name:OMAR, HAFSA ABDIFATAH (PA)
Entity type:Individual
Prefix:
First Name:HAFSA
Middle Name:ABDIFATAH
Last Name:OMAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2487 S GILBERT RD STE 106-486
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-8899
Mailing Address - Country:US
Mailing Address - Phone:480-699-5536
Mailing Address - Fax:480-699-9283
Practice Address - Street 1:2100 E YEAGER DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-1598
Practice Address - Country:US
Practice Address - Phone:480-699-5536
Practice Address - Fax:480-699-9283
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant