Organization
PERFORMANCE BOOST CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN GLASSMAN (OWNER)
(626) 388-0700
Entity
Organization
Contact information
Practice address
1501 SUPERIOR AVE STE 304, NEWPORT BEACH, CA 92663-3641
(949) 612-7811
(848) 612-7822
Mailing address
1501 SUPERIOR AVE STE 304, NEWPORT BEACH, CA 92663-3641
(949) 612-7811
(848) 612-7822
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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