=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093111601
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARON BELL'S MASSAGE & PAIN CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2014
-----------------------------------------------------
Last Update Date | 11/08/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8072 CALIFORNIA CITY BLVD
-----------------------------------------------------
City | CALIFORNIA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93505-2661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-373-1952
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8072 CALIFORNIA CITY BLVD
-----------------------------------------------------
City | CALIFORNIA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93505-2661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-373-1952
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | SHARON ANN BELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 760-373-1952
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QP3300X
-----------------------------------------------------
Taxonomy Name | Pain Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------