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Organization

BODY SYNTHESIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAVARES ALLEN GARRETT CNC (CERTIFIED NUTRITION COACH)
(818) 813-4300
Entity
Organization

Contact information

Practice address
8439 N LAKE DR APT G, DUBLIN, CA 94568-3359
(818) 813-4300
Mailing address
8439 N LAKE DR APT G, DUBLIN, CA 94568-3359
(818) 813-4300

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QH0100X
Health Service Clinic/Center
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
07/26/2022
Last updated
07/26/2022
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