| Mindworks Connection Professional Nursing Corporation | |
|
Mindworks Connection 1968 S Coast Hwy # 4560 Laguna Beach CA 92651-3681 | |
| (425) 615-4312 | |
| Not Available |
| Full Name | Mindworks Connection Professional Nursing Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | Mindworks Connection, Laguna Beach, California |
| Authorized Official Name and Position | Kumbirai Madiye (PRESIDENT) |
| Authorized Official Contact | 8082211039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindworks Connection Professional Nursing Corporation 1968 S Coast Hwy # 4560 Laguna Beach CA 92651-3681 Ph: (425) 615-4312 | Mindworks Connection Professional Nursing Corporation Mindworks Connection 1968 S Coast Hwy # 4560 Laguna Beach CA 92651-3681 Ph: (425) 615-4312 |
| NPI Number | 1417604422 |
|---|---|
| Provider Enumeration Date | 03/09/2022 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Medicare PECOS PAC ID | 1052798253 |
|---|---|
| Medicare Enrollment ID | O20220509001763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417604422 | NPI | - | NPPES |
| Provider Name | Kumbirai Madiye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427563535 PECOS PAC ID: 6103170626 Enrollment ID: I20181119002126 |
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