Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Omar Ibarra

Individual provider Physician Assistant · NPI 1548025570

Omar Ibarra is a Physician Assistant in Fremont, California. Qualified in 2024, 2 years ago. Practices with Mendocino Community Health Clinic Inc, a 58-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
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Practice location Address checks out

40910 Fremont Blvd
Fremont, CA 94538-4375
Phone: (510) 770-8040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA64594 (CA)

Record details

NPI number1548025570
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 19, 2024
Last updated in NPPESApril 8, 2026
Certification dateApril 8, 2026
Mailing address40910 Fremont Blvd, Fremont, CA 94538-4375

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mendocino Community Health Clinic Inc — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fremont