Organization
MAYVENN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIISHAN IMIRA (CEO)
(305) 742-4812
Entity
Organization
Contact information
Practice address
2201 BROADWAY, OAKLAND, CA 94612-3017
(855) 287-6868
Mailing address
1423 BROADWAY, OAKLAND, CA 94612-2054
(855) 287-6868
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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