| Proactivehealthllc | |
|
17601 17th St Ste 120 Tustin CA 92780-1946 | |
| (657) 210-4547 | |
| Not Available |
| Full Name | Proactivehealthllc |
|---|---|
| Speciality | Clinic/center |
| Location | 17601 17th St Ste 120, Tustin, California |
| Authorized Official Name and Position | Manwell Soliman (CEO) |
| Authorized Official Contact | 5626586766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactivehealthllc 17601 17th St Ste 120 Tustin CA 92780-1946 Ph: (657) 210-4547 | Proactivehealthllc 17601 17th St Ste 120 Tustin CA 92780-1946 Ph: (657) 210-4547 |
| NPI Number | 1083584023 |
|---|---|
| Provider Enumeration Date | 11/06/2025 |
| Last Update Date | 11/06/2025 |
| Certification Date | 11/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083584023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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