Healthcare Provider Details

I. General information

NPI: 1457959496
Provider Name (Legal Business Name): MEDITAS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4068 PARK VISTA DR
PASADENA CA
91107-1322
US

IV. Provider business mailing address

4068 PARK VISTA DR
PASADENA CA
91107-1322
US

V. Phone/Fax

Practice location:
  • Phone: 310-977-5444
  • Fax:
Mailing address:
  • Phone: 310-977-5444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MORTEZA AMINI
Title or Position: CEO
Credential: FMG, EMBA, MIBA, MSN
Phone: 310-977-5444