MEDICARE: HEALTH GUARD FITNESS

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	251J00000X	Nursing Care Agency	662376	CA

General Provider Information

NPI Number	:	1104146729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH GUARD FITNESS

Provider Business Mailing Address
First Line	:	2915 LLOYD ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-6031
Country	:	US
Telephone Number	:	858-997-5029
Fax Number	:	619-684-1374

Provider Business Practice Location Address
First Line	:	2915 LLOYD ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-6031
Country	:	US
Telephone Number	:	858-997-5029
Fax Number	:	619-684-1374

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SARA EMILY PEREZ
Credential	:	R.N.
Telephone Number	:	858-997-5029

Provider Enumeration Date	:	06/04/2010
Last Update Date	:	06/04/2010

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Directions to “HEALTH GUARD FITNESS ” Practice Location

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