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General NPI Number Information
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NPI Number | 1538355912
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Entity Type | Organization
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Legal Business Name | ON CENTER CONDITIONING BODY, ARTS, AND SCIENCES
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 485 E 17TH ST STE 650
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City | COSTA MESA
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State | CA
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Zip | 92627-4706
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Country | US
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Telephone | 866-992-2742
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Fax | 949-642-8139
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Provider Business Mailing Address
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Address Line | 485 E 17TH ST STE 650
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City | COSTA MESA
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State | CA
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Zip | 92627-4706
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Country | US
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Telephone | 866-992-2742
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Fax | 949-642-8139
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Authorized Official
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Title or Position | DIRECTOR, FOUNDER
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Name | MR. RAEL ISACOWITZ
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Credential | M.A.
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Telephone | 866-992-2742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | BL009112
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License Number State | CA
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