Miracle Wands Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

54418 Issued in CA

Legal business name

MIRACLE WANDS CLINIC

Practice address

1143 Story Rd Ste 250&260
San Jose, CA 95122-2610

Phone

(408) 899-2254

NPI assigned

Mar 27, 2017

Last updated

Mar 27, 2017By 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

Mrs. Lyndy Ngu

Title

Ceo

Phone

(213) 271-5925

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1528599842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 STORY RD STE 250&260",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222610",
            "telephone_number": "408-899-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 STORY RD STE 250&260",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222610",
            "telephone_number": "408-899-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE WANDS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "NGU",
        "authorized_official_first_name": "LYNDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-271-5925",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "54418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melina Pilar Minor, ACSW
• Mintz Medical Corporation
• Senija Miocevic, RD
• Alex A Mirabadi, M.D.
• Marjereen Mirabueno
• Hafiz M. Miraly, MD
• Christina Marie Miramon-Gomez
• Nathan Andre Miramon
• Nicole D Miramontes
• Osvaldo I Miranda Medina

• Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.