Healthcare Provider Details

I. General information

NPI: 1245414242
Provider Name (Legal Business Name): MINAKA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24102 EL TORO RD STE I
LAGUNA HILLS CA
92637-3123
US

IV. Provider business mailing address

24102 EL TORO RD STE I
LAGUNA HILLS CA
92637-3123
US

V. Phone/Fax

Practice location:
  • Phone: 949-455-0404
  • Fax:
Mailing address:
  • Phone: 949-455-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KAMRAN NAKHAEE
Title or Position: PRESIDENT
Credential:
Phone: 949-455-0404