Active NPI
Proactivehealthllc
- Clinic/Center
- Tustin, CA
National Provider Identifier
1083584023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- PROACTIVEHEALTHLLC
- Practice address
- 17601 17TH St Ste 120
Tustin, CA 92780-1946 - Phone
- (657) 210-4547
- NPI assigned
- Nov 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Manwell Soliman
- Title
- Ceo
- Phone
- (562) 658-6766
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
17601 17TH St Ste 120
Tustin, CA 92780-1946
Mailing address
17601 17TH St Ste 120
Tustin, CA 92780-1946
Phone (657) 210-4547
National Provider Directory
National Provider DirectoryLocations
17601 17th St
Ste 120
Tustin, CA 92780
Phone (657) 210-4547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762387200000",
"number": "1083584023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17601 17TH ST STE 120",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927801946",
"telephone_number": "657-210-4547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17601 17TH ST STE 120",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927801946",
"telephone_number": "657-210-4547"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROACTIVEHEALTHLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-11-06",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A",
"authorized_official_last_name": "SOLIMAN",
"authorized_official_first_name": "MANWELL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "562-658-6766"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.