Minervo

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MINERVO

Doing business as

Rage Ground

Practice address

1120 1/2 S Main St
Los Angeles, CA 90015-2541

Phone

(213) 536-5356

NPI assigned

Jan 31, 2019

Last updated

Jan 31, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edwin Javier Toribio

Title

Coo

Phone

(323) 793-3128

Specialties & licenses 1

Addresses

Other names 1

• Rage Ground Doing business as

Locations

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1164987467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 1/2 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152541",
            "telephone_number": "213-536-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 1/2 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152541",
            "telephone_number": "213-536-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERVO",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "TORIBIO",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "JAVIER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "323-793-3128",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rage Ground",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Diane Miner, NP
• Rayshaun Miner
• Mark Anthony Minera
• Laura Patricia Minero Meza, PHD, LP
• Minerva Mental Health P.C.
• Peyton Mei Ming
• Minghsun Liu, M.D., PC (Woundtech of California)
• Minghsun Liu, M.D., PH.D., P.C.
• Patrick Mingledorff, DO
• Dahmenah Mingo

• Community/Behavioral Health Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.