Provider Demographics
NPI:1417348749
Name:BZ HEALTH - SANTA MONICA
Entity type:Organization
Organization Name:BZ HEALTH - SANTA MONICA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-584-7247
Mailing Address - Street 1:PO BOX 4367
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-4367
Mailing Address - Country:US
Mailing Address - Phone:949-750-2009
Mailing Address - Fax:949-396-2614
Practice Address - Street 1:1912 N BATAVIA ST STE D
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-4139
Practice Address - Country:US
Practice Address - Phone:949-750-2009
Practice Address - Fax:949-396-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization