NPIMap

Organization Active NPI

Miramar Health Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Costa Mesa, CA
National Provider Identifier
1205371341
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
300182DP Issued in CA
Legal business name
MIRAMAR HEALTH INC
Practice address
2165 Harbor Blvd
Costa Mesa, CA 92627-2529
Phone
(949) 415-7714
NPI assigned
Dec 28, 2016
Last updated
Dec 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Mr. Derik Brian
Title
Owner
Phone
(949) 370-0771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X 300182DP CA Primary

Addresses

Primary practice location

2165 Harbor Blvd
Costa Mesa, CA 92627-2529

Mailing address

812 Emerald Bay
Laguna Beach, CA 92651-1273
Phone (949) 370-0771

National Provider Directory

National Provider Directory
Tax ID family
Miramar Health Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1205371341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 EMERALD BAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511273",
            "telephone_number": "949-370-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272529",
            "telephone_number": "949-415-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAMAR HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "BRIAN",
        "authorized_official_first_name": "DERIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-370-0771",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "CA",
            "license": "300182DP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.