| Brainpower Wellness Institute Nursing Corporation | |
|
1310 W Stewart Dr Ste 301 Orange CA 92868-3838 | |
| (714) 712-0711 | |
| (657) 224-4781 |
| Full Name | Brainpower Wellness Institute Nursing Corporation |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1310 W Stewart Dr Ste 301, Orange, California |
| Authorized Official Name and Position | Taqialdeen Zamil (CEO) |
| Authorized Official Contact | 7147120711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainpower Wellness Institute Nursing Corporation 1310 W Stewart Dr Ste 301 Orange CA 92868-3838 Ph: (714) 712-0711 | Brainpower Wellness Institute Nursing Corporation 1310 W Stewart Dr Ste 301 Orange CA 92868-3838 Ph: (714) 712-0711 |
| NPI Number | 1528573615 |
|---|---|
| Provider Enumeration Date | 12/11/2017 |
| Last Update Date | 02/06/2022 |
| Certification Date | 07/25/2021 |
| Medicare PECOS PAC ID | 3072840586 |
|---|---|
| Medicare Enrollment ID | O20190806004155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528573615 | NPI | - | NPPES |
| Provider Name | Taqialdeen Zamil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598154478 PECOS PAC ID: 8921389099 Enrollment ID: I20170103001574 |
| Provider Name | Penelope Dawn Greaves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710420807 PECOS PAC ID: 4688957608 Enrollment ID: I20170216001321 |
| Provider Name | Roberta Gordin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518458793 PECOS PAC ID: 4587056866 Enrollment ID: I20220118002247 |
| Provider Name | Catvy N Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770605156 PECOS PAC ID: 3870971559 Enrollment ID: I20220608002756 |
| Provider Name | Mariam Fazil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235827429 PECOS PAC ID: 5597125849 Enrollment ID: I20230718002080 |
| Provider Name | Samir Hamed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568166965 PECOS PAC ID: 8628427200 Enrollment ID: I20231207002072 |
| Provider Name | Brittany Lute |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477148450 PECOS PAC ID: 7719336478 Enrollment ID: I20240124002427 |
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