Omar Minwalla, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

20244 Issued in CA

Practice address

400 S Beverly Dr Ste 316
Beverly Hills, CA 90212-4405

Phone

(310) 286-1300

Fax

(310) 286-1330

NPI assigned

Dec 22, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1942539945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S BEVERLY DR STE 316",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124405",
            "telephone_number": "310-286-1300",
            "fax_number": "310-286-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BEVERLY DR STE 316",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124405",
            "telephone_number": "310-286-1300",
            "fax_number": "310-286-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINWALLA",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "20244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sean Miranda

• Cognitive & Behavioral Psychologist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.