=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457155699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MASSAGE PRO GROUP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2025
-----------------------------------------------------
Last Update Date | 04/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14168 POWAY RD STE 206
-----------------------------------------------------
City | POWAY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92064-4939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-288-2600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14168 POWAY RD STE 206
-----------------------------------------------------
City | POWAY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92064-4939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | HONG YAN SAINDON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 858-531-9767
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------