Healthcare Provider Details

I. General information

NPI: 1306607239
Provider Name (Legal Business Name): HEALTHON INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 12/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ODESSEY, SUITE 240
IRVINE CA
92618
US

IV. Provider business mailing address

100 SPECTRUM CENTER DR STE 900
IRVINE CA
92618-4974
US

V. Phone/Fax

Practice location:
  • Phone: 949-668-7000
  • Fax:
Mailing address:
  • Phone: 949-668-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RASOUL M MONTAZERI
Title or Position: CEO
Credential: DO
Phone: 949-291-7563