Provider Demographics
NPI:1750944393
Name:NONAY, MINA MAHER
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:MAHER
Last Name:NONAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13601 ESPIRIT WAY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3216
Mailing Address - Country:US
Mailing Address - Phone:817-317-6268
Mailing Address - Fax:
Practice Address - Street 1:21572 PLANO TRABUCO RD
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-3465
Practice Address - Country:US
Practice Address - Phone:949-589-3792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist