Healthcare Provider Details

I. General information

NPI: 1942130901
Provider Name (Legal Business Name): XSPAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 N OCEAN DR APT P405
RIVIERA BEACH FL
33404-3214
US

IV. Provider business mailing address

3100 N OCEAN DR APT P405
RIVIERA BEACH FL
33404-3214
US

V. Phone/Fax

Practice location:
  • Phone: 949-307-8249
  • Fax:
Mailing address:
  • Phone: 949-307-8249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SONALI S NAMIRANIAN
Title or Position: CO-FOUNDER & CSO
Credential:
Phone: 949-307-8249