Delaram Devorah Omidfar, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95031576 Issued in CA

Practice address

6243 Tampa Ave
Tarzana, CA 91335-6644

Phone

(818) 602-8512

NPI assigned

Nov 26, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1356167191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6243 TAMPA AVE",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356644",
            "telephone_number": "818-602-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6243 TAMPA AVE",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356644",
            "telephone_number": "818-602-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIDFAR",
        "first_name": "DELARAM",
        "middle_name": "DEVORAH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "95089153",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95031576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ofelia Oliveros
• Leslie Olmos
• Olga Olshansky, PHARMD
• Edward Olson
• Olympus Hospice Inc
• One Veritas Pharmacy
• One Veritas Pharmacy
• James J Ong, M.D.
• Alexandra Ontiveros, L.AC
• Jessica Elizabeth Ontiveros

• Primary Care Nurse Practitioner in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.