Healthcare Provider Details

I. General information

NPI: 1417810516
Provider Name (Legal Business Name): VITAL MIND PSYCHIATRY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2372 MORSE AVE STE 421
IRVINE CA
92614-6234
US

IV. Provider business mailing address

27371 DESERT WILLOW ST
MURRIETA CA
92562-4390
US

V. Phone/Fax

Practice location:
  • Phone: 951-899-0127
  • Fax: 951-889-0127
Mailing address:
  • Phone: 951-899-0127
  • Fax: 951-899-0127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SAMIR M HAMED
Title or Position: OWNER
Credential: PMHNP
Phone: 714-820-0619