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General NPI Number Information
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NPI Number | 1457205627
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Entity Type | Organization
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Legal Business Name | MNICOLEIRWIN INC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 2701 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90806-2701
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Country | US
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Telephone | 714-377-6993
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Fax | 562-247-9808
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Provider Business Mailing Address
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Address Line | PO BOX 5962
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92615-5962
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Country | US
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Telephone | 714-389-8133
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Fax | 562-424-1027
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELANIE IRWIN
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Credential | MD
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Telephone | 714-389-8133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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