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NPI Code Detail

MEDICARE: SPINEZONE MEDICAL FITNESS, INC.

MEDICARE: SPINEZONE MEDICAL FITNESS, 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1659915015
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINEZONE MEDICAL FITNESS, INC.
Provider Business Mailing Address
First Line : 7525 METROPOLITAN DR STE 306
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4404
Country : US
Telephone Number : 844-316-7979
Fax Number : 866-813-1235
Provider Business Practice Location Address
First Line : 1828 OCEANSIDE BLVD
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-3452
Country : US
Telephone Number : 844-316-7979
Fax Number : 866-813-1235
Authorized Official
Title or Position : BILLING MANAGER / CREDENTIALING
Name : IVANIA CASTLE
Credential :
Telephone Number : 619-432-4634
Provider Enumeration Date : 10/29/2019
Last Update Date : 09/15/2022

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Directions to “SPINEZONE MEDICAL FITNESS, INC. ” Practice Location

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