Mirfendereski, Omid

Mirfendereski, Omid is an individual health care provider with primary practice located at 3110 Kerner Blvd , San Rafael CA 94901-5411. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Mirfendereski, Omid can be contacted via phone (415) 448-1500.

Contact Information

Primary practice address
3110 Kerner Blvd San Rafael CA 94901-5411
Phone: (415) 448-1500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 106243 California

Profile Details

NPI number 1891369641
LBN Legal business name Mirfendereski, Omid
Credentials DDS, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2021
Last updated Jun 16th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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