Provider Demographics
NPI:1003261538
Name:ZEN CENTER FOR PAIN MANAGEMENT & WELLNESS
Entity Type:Organization
Organization Name:ZEN CENTER FOR PAIN MANAGEMENT & WELLNESS
Other - Org Name:MEDIC 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DINORA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVA OLESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-263-7202
Mailing Address - Street 1:1835 W REDLANDS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-3118
Mailing Address - Country:US
Mailing Address - Phone:951-263-7202
Mailing Address - Fax:949-269-0672
Practice Address - Street 1:1835 W REDLANDS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-3118
Practice Address - Country:US
Practice Address - Phone:951-263-7202
Practice Address - Fax:949-269-0672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain