Mindful Glow

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MINDFUL GLOW

Doing business as

Mindful Glow Medical Corporation

Practice address

18111 Brookhurst St Ste 5400
Fountain Valley, CA 92708-6728

Phone

(949) 436-4666

NPI assigned

Feb 15, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tam DO, PMHNP, FNPNPI 1801426192

Title

Ceo

Phone

(949) 436-4666

Specialties & licenses 4

Addresses

Other names 2

• Mindful Glow Medical Corporation Doing business as
• Mindful Glow Inc Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tam DO

  • Psychiatric/Mental Health Nurse Practitioner
  • Costa Mesa, CA
  • NPI 1801426192
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1033914924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 5400",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 5400",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "949-436-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL GLOW",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-15",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "TAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-436-4666",
        "authorized_official_credential": "PMHNP, FNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Glow Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindful Glow Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mindful Glow Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Francis Miller, DC
• Susan Colette Mills, RD
• Esther Min, PHARMD
• Minal D Tapadia MD Inc
• Minal Mehta MD a Professional Corporation (Socal Obgyn)
• Minh Mach, MD Inc.
• Minh-Tri Nguyen Dental Corp.
• Miramar Consulting LLC (Dialysis Ambulance Transport)
• Johanna Miramontes-Lugo
• Mahmood Mirbagheri, MD

• Multi-Specialty Clinic/Center in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.