Provider Demographics
NPI:1245820935
Name:MINAEI, HOMMED (DC)
Entity type:Individual
Prefix:DR
First Name:HOMMED
Middle Name:
Last Name:MINAEI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W LA PALMA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3661
Mailing Address - Country:US
Mailing Address - Phone:413-687-9245
Mailing Address - Fax:
Practice Address - Street 1:1011 W LA PALMA AVE STE 101
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3661
Practice Address - Country:US
Practice Address - Phone:714-758-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010479111N00000X
CA36191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor