MEDICARE: BACK TO BALANCE INC

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	231H00000X	Audiologist

General Provider Information

NPI Number	:	1700804531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK TO BALANCE INC

Provider Business Mailing Address
First Line	:	16161 VENTURA BLVD
Second Line	:	STE 215
City	:	ENCINO
State	:	CA
Zip	:	91436
Country	:	US
Telephone Number	:	818-788-4513
Fax Number	:	818-788-4523

Provider Business Practice Location Address
First Line	:	1700 E CESAR E CHAVEZ AVE
Second Line	:	2300
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2424
Country	:	US
Telephone Number	:	323-260-7420
Fax Number	:	323-260-7426

Authorized Official
Title or Position	:	CEO
Name	:	IZHAK PAZ
Credential	:
Telephone Number	:	323-260-7420

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/02/2010

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Directions to “BACK TO BALANCE INC ” Practice Location

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