Provider Demographics
NPI:1992464887
Name:DAAHIR, OLIVER (SOIDC)
Entity type:Individual
Prefix:MR
First Name:OLIVER
Middle Name:
Last Name:DAAHIR
Suffix:
Gender:M
Credentials:SOIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6430 N CAMINO PADRE ISIDORO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2032
Mailing Address - Country:US
Mailing Address - Phone:520-861-0660
Mailing Address - Fax:
Practice Address - Street 1:1ST RECONNAISSANCE BT
Practice Address - Street 2:
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-390-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman