MEDICARE: MOTIONHEALTH

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1750895363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTIONHEALTH

Provider Business Mailing Address
First Line	:	2230 PROFESSIONAL DR STE A
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-3015
Country	:	US
Telephone Number	:	707-595-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	3449 FREEDOM PARK DR
Second Line	:
City	:	NORTH HIGHLANDS
State	:	CA
Zip	:	95660-4607
Country	:	US
Telephone Number	:	866-632-6627
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	RONALD JOHNSON
Credential	:
Telephone Number	:	510-879-7385

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	11/20/2017

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Directions to “MOTIONHEALTH ” Practice Location

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