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NPI Code Detail

MEDICARE: AUSTIN BRIAN ZUERLEIN ATC

MEDICARE: AUSTIN BRIAN ZUERLEIN ATC
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1770554388
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUSTIN BRIAN ZUERLEIN ATC
Provider Business Mailing Address
First Line : 16792 TALISMAN LN
Second Line : APT. 104
City : HUNTINGTON BEACH
State : CA
Zip : 92649-3136
Country : US
Telephone Number : 215-962-9545
Fax Number :
Provider Business Practice Location Address
First Line : 16792 TALISMAN LN
Second Line : APT. 104
City : HUNTINGTON BEACH
State : CA
Zip : 92649-3136
Country : US
Telephone Number : 215-962-9545
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 07/08/2007

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