Mirette Attalla

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

10431 Slater Ave Apt 204
Fountain Valley, CA 92708-7706

Phone

(424) 361-8431

NPI assigned

Apr 28, 2023

Last updated

Dec 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1184312977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10431 SLATER AVE APT 204",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087706",
            "telephone_number": "424-361-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10431 SLATER AVE APT 204",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087706",
            "telephone_number": "424-361-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTALLA",
        "first_name": "MIRETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS109258",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS109258",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Assif, MD
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• Huma Athar-Macdonald, PSYD
• Athenolan Pharmaceutical Inc (Tao Wellness Pharmacy)
• Mundi Li Attinasi, MD
• Frederick N. Atuatasi
• Michael Audon, MD
• Austin Shiou Lin, M.D., Inc.
• Fernando H Austin, MD

• Student in an Organized Health Care Education/Training Program in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.