Provider Demographics
NPI:1336942317
Name:MINA, GEORGE RAFEEK
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:RAFEEK
Last Name:MINA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-4429
Mailing Address - Country:US
Mailing Address - Phone:714-809-1939
Mailing Address - Fax:
Practice Address - Street 1:2861 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-4429
Practice Address - Country:US
Practice Address - Phone:714-809-1939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program