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General NPI Number Information
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NPI Number | 1609689611
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Entity Type | Organization
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Legal Business Name | MINDFULOUS INC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 1409 N NORMA ST
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City | RIDGECREST
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State | CA
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Zip | 93555-2510
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Country | US
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Telephone | 415-372-0892
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Fax | 866-305-3569
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Provider Business Mailing Address
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Address Line | 2021 FILLMORE ST # 2142
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-2708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DR. HANI CHAABO
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Credential | MD
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Telephone | 415-375-0892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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