Mirette Attalla, is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Fountain Valley, California. Her current practice location is
10431 Slater Ave Apt 204, Fountain Valley, California. You can reach out to her office (for appointments etc.) via phone at
(424) 361-8431.
Mirette Attalla is licensed to practice in California (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184312977.
Healthcare Provider's Profile
| Full Name | Mirette Attalla |
|---|
| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 10431 Slater Ave Apt 204, Fountain Valley, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1184312977
- Provider Enumeration Date: 04/28/2023
- Last Update Date: 12/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 6608218359
- Enrollment ID: I20240524003532
Medical Identifiers
Medical identifiers for Mirette Attalla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184312977 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | DDS109258 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | DDS109258 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mirette Attalla is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mirette Attalla,
10431 Slater Ave Apt 204,
Fountain Valley, CA 92708-7706
Ph: (424) 361-8431 | Mirette Attalla,
10431 Slater Ave Apt 204,
Fountain Valley, CA 92708-7706
Ph: (424) 361-8431 |
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