Organization Active NPI

Omran MD Inc

  • Cardiovascular Disease Physician
  • San Diego, CA
National Provider Identifier
1902623317
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
OMRAN MD INC
Practice address
4060 Fourth Ave Ste 500
San Diego, CA 92103-2121
Phone
(619) 260-1900
Fax
(619) 260-1919
NPI assigned
Sep 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Jad Omran, MDNPI 1366720211
Title
President
Phone
(573) 489-5417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

4060 Fourth Ave Ste 500
San Diego, CA 92103-2121

Mailing address

4060 Fourth Ave Ste 500
San Diego, CA 92103-2121
Phone (619) 260-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250116004037 CA Part B Supplier - Clinic/Group Practice 2466980537 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1902623317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE STE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-260-1900",
            "fax_number": "619-260-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE STE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-260-1900",
            "fax_number": "619-260-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMRAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "OMRAN",
        "authorized_official_first_name": "JAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-489-5417",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.