MEDICARE: RESTORING SYNERGY 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	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1780521138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORING SYNERGY LLC

Provider Business Mailing Address
First Line	:	9187 CLAIREMONT MESA BLVD STE 6-730
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1257
Country	:	US
Telephone Number	:	619-665-7562
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 CAMINO DE LA REINA
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3007
Country	:	US
Telephone Number	:	619-665-7562
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RODNEY L. FOWLER JR.
Credential	:
Telephone Number	:	619-665-7562

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “RESTORING SYNERGY LLC ” Practice Location

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