Provider Demographics
NPI:1497881130
Name:TOHID, MINA (RDCS)
Entity Type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:TOHID
Suffix:
Gender:F
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RIPPLING STRM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-3421
Mailing Address - Country:US
Mailing Address - Phone:310-254-7979
Mailing Address - Fax:949-679-3062
Practice Address - Street 1:12792 VALLEY VIEW ST
Practice Address - Street 2:#B1
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2526
Practice Address - Country:US
Practice Address - Phone:310-254-7979
Practice Address - Fax:714-894-3121
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174318246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAY29553Medicare UPIN