Healthcare Provider Details

I. General information

NPI: 1497881130
Provider Name (Legal Business Name): MINA TOHID R.D.C.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12792 VALLEY VIEW ST #B1
GARDEN GROVE CA
92845-2526
US

IV. Provider business mailing address

13 RIPPLING STRM
IRVINE CA
92603-3421
US

V. Phone/Fax

Practice location:
  • Phone: 310-254-7979
  • Fax: 714-894-3121
Mailing address:
  • Phone: 310-254-7979
  • Fax: 949-679-3062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number174318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: