Provider Demographics
NPI:1205384260
Name:MOTIONHEALTH
Entity Type:Organization
Organization Name:MOTIONHEALTH
Other - Org Name:MOTIONHEALTH EUREKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:866-632-6627
Mailing Address - Street 1:405 14TH ST
Mailing Address - Street 2:SUITE 712
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2715
Mailing Address - Country:US
Mailing Address - Phone:866-632-6627
Mailing Address - Fax:
Practice Address - Street 1:2365 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3216
Practice Address - Country:US
Practice Address - Phone:707-798-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service