Healthcare Provider Details
I. General information
NPI: 1265320782
Provider Name (Legal Business Name): TRIPTI-V, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23 CORPORATE PLAZA DR STE 150-88
NEWPORT BEACH CA
92660-7911
US
IV. Provider business mailing address
23 CORPORATE PLAZA DR STE 150-88
NEWPORT BEACH CA
92660-7911
US
V. Phone/Fax
- Phone: 805-699-6670
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
NASIR
Title or Position: DO
Credential: DO
Phone: 805-619-2995