Healthcare Provider Details

I. General information

NPI: 1225593601
Provider Name (Legal Business Name): TRUSELF TRAINING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2019
Last Update Date: 02/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5125 WARING ROAD
SAN DIEGO CA
92120
US

IV. Provider business mailing address

5125 WARING RD
SAN DIEGO CA
92120-2705
US

V. Phone/Fax

Practice location:
  • Phone: 619-431-5407
  • Fax:
Mailing address:
  • Phone: 619-431-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSH PEREZ
Title or Position: GENERAL MANAGER
Credential:
Phone: 619-431-5407