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Organization
HIZON MEDICAL CORPORATION
Active
Organization
HIZON MEDICAL CORPORATION
Active
Parent organization
MEDVANTX, INC.
Other names
Motion Sports MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
25495 MEDICAL CENTER DR, SUITE 305, MURRIETA, CA 92562-4902
(951) 790-0107
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G55359
CA
Other
Enumeration date
09/23/2013
Last updated
05/19/2014
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