Organization
MY90HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GINOS III (OWNER)
(480) 234-2333
Entity
Organization
Contact information
Practice address
32460 CROWN VALLEY PKWY, # 107, DANA POINT, CA 92629-3302
(949) 481-5925
Mailing address
32460 CROWN VALLEY PKWY, # 107, DANA POINT, CA 92629-3302
(949) 481-5925
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
132700000X
Dietary Manager
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
174400000X
Specialist
—
—
174H00000X
Health Educator
—
—
175F00000X
Naturopath
—
—
175L00000X
Homeopath
—
—
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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