Healthcare Provider Details
I. General information
NPI: 1376326157
Provider Name (Legal Business Name): MILANI HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3900 BIRCH ST STE 113
NEWPORT BEACH CA
92660-2226
US
IV. Provider business mailing address
3900 BIRCH ST STE 113
NEWPORT BEACH CA
92660-2226
US
V. Phone/Fax
- Phone: 941-883-1945
- Fax:
- Phone: 941-883-1945
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0201X |
| Taxonomy | Allergy & Immunology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SANJAI
MATHEW
THANKACHEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 714-782-4700