Organization
MIRAMAR HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERIK BRIAN (OWNER)
(949) 370-0771
Entity
Organization
Contact information
Practice address
2165 HARBOR BLVD, COSTA MESA, CA 92627-2529
(949) 415-7714
Mailing address
812 EMERALD BAY, LAGUNA BEACH, CA 92651-1273
(949) 370-0771
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
300182DP
CA
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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