Organization
MINDFUL GLOW
Active
Organization
MINDFUL GLOW
Active
Other names
Mindful Glow Medical Corporation, Mindful Glow Inc
Organization subpart
No
Provider details
NPI number
Authorized official
TAM DO PMHNP, FNP (CEO)
(949) 436-4666
Entity
Organization
Contact information
Practice address
18111 BROOKHURST ST STE 5400, FOUNTAIN VALLEY, CA 92708-6728
(949) 436-4666
Mailing address
18111 BROOKHURST ST STE 5400, FOUNTAIN VALLEY, CA 92708-6728
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
02/15/2025
Last updated
04/11/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up