Healthcare Provider Details

I. General information

NPI: 1669396982
Provider Name (Legal Business Name): CORWELL MEDICAL PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3324 E MANDEVILLE PL
ORANGE CA
92867-2071
US

IV. Provider business mailing address

3324 E MANDEVILLE PL
ORANGE CA
92867-2071
US

V. Phone/Fax

Practice location:
  • Phone: 714-683-2970
  • Fax: 714-683-0925
Mailing address:
  • Phone: 714-683-2970
  • Fax: 714-683-0925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMESH H RATHOD
Title or Position: PRESIDENT
Credential: MD
Phone: 714-683-2970