Provider Demographics
NPI:1063582112
Name:OHADI, CAMIAR (MD)
Entity type:Individual
Prefix:DR
First Name:CAMIAR
Middle Name:
Last Name:OHADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11088 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7676
Mailing Address - Country:US
Mailing Address - Phone:909-625-2000
Mailing Address - Fax:909-625-2099
Practice Address - Street 1:9655 MONTEVISTA AVE STE 403
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763
Practice Address - Country:US
Practice Address - Phone:909-625-2000
Practice Address - Fax:909-625-2099
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG798072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2832233Medicaid
CAG79807OtherLIC NUMBER
CA2832233Medicaid
CAH84892Medicare UPIN