MEDICARE: HEALTHZONE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	16931	CA

General Provider Information

NPI Number	:	1598106890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHZONE, INC

Provider Business Mailing Address
First Line	:	507 29TH ST
Second Line	:	UNIT B
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3762
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 29TH ST
Second Line	:	UNIT B
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3762
Country	:	US
Telephone Number	:	562-715-0584
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	DARCI THARP
Credential	:	MPT
Telephone Number	:	562-715-0584

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	07/15/2013

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Directions to “HEALTHZONE, INC ” Practice Location

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