Provider Demographics
NPI:1104146729
Name:HEALTH GUARD FITNESS
Entity type:Organization
Organization Name:HEALTH GUARD FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:EMILY
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:858-997-5029
Mailing Address - Street 1:2915 LLOYD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6031
Mailing Address - Country:US
Mailing Address - Phone:858-997-5029
Mailing Address - Fax:619-684-1374
Practice Address - Street 1:2915 LLOYD ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6031
Practice Address - Country:US
Practice Address - Phone:858-997-5029
Practice Address - Fax:619-684-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA662376251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care