Healthcare Provider Details

I. General information

NPI: 1679280432
Provider Name (Legal Business Name): HEAL ENDOCRINE & DIABETES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26800 CROWN VALLEY PKWY STE 485
MISSION VIEJO CA
92691-8025
US

IV. Provider business mailing address

26800 CROWN VALLEY PKWY STE 485
MISSION VIEJO CA
92691-8025
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-5830
  • Fax:
Mailing address:
  • Phone: 949-364-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERENE NAWAR SAMI
Title or Position: PRESIDENT
Credential: MD
Phone: 949-683-4772