MEDICARE: MIRAMAR HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1124725015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRAMAR HEALTH INC

Provider Business Mailing Address
First Line	:	23293 S POINTE DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 S MINTER ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-1842
Country	:	US
Telephone Number	:	949-989-2626
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TOM SAUER
Credential	:
Telephone Number	:	425-505-1394

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	02/01/2024

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Directions to “MIRAMAR HEALTH INC ” Practice Location

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