Healthcare Provider Details

I. General information

NPI: 1083537492
Provider Name (Legal Business Name): NORIMIND MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11335 LOS OSOS VALLEY RD APT C
SAN LUIS OBISPO CA
93405-6357
US

IV. Provider business mailing address

11335 LOS OSOS VALLEY RD APT C
SAN LUIS OBISPO CA
93405-6357
US

V. Phone/Fax

Practice location:
  • Phone: 805-835-6535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ABDELLATIF ANTHONY AICHOURI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 805-440-6671