Healthcare Provider Details

I. General information

NPI: 1336073964
Provider Name (Legal Business Name): MUDHAR WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 SPECTRUM # 3300
IRVINE CA
92618-3374
US

IV. Provider business mailing address

3300 SPECTRUM # 3300
IRVINE CA
92618-3374
US

V. Phone/Fax

Practice location:
  • Phone: 949-283-1466
  • Fax:
Mailing address:
  • Phone: 949-283-1466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: BARAA R MUDHAR
Title or Position: OWNER/OPERATOR
Credential:
Phone: 949-283-1466