MEDICARE: ZION HEALING CENTER SOCAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1003696055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZION HEALING CENTER SOCAL LLC

Provider Business Mailing Address
First Line	:	330 S MAGNOLIA AVE STE 203
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-5224
Country	:	US
Telephone Number	:	858-829-4701
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 S MAGNOLIA AVE STE 203
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-5224
Country	:	US
Telephone Number	:	619-350-0302
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARVIN RAZUKI
Credential	:
Telephone Number	:	858-829-4701

Provider Enumeration Date	:	10/05/2023
Last Update Date	:	03/16/2026

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Directions to “ZION HEALING CENTER SOCAL LLC ” Practice Location

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