Provider Demographics
NPI:1023520111
Name:REACTIVE MEDICAL CENTER, INC
Entity type:Organization
Organization Name:REACTIVE MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUZELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-388-8993
Mailing Address - Street 1:31411 CAMINO CAPISTRANO STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2676
Mailing Address - Country:US
Mailing Address - Phone:949-388-8993
Mailing Address - Fax:
Practice Address - Street 1:31411 CAMINO CAPISTRANO STE 700
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2676
Practice Address - Country:US
Practice Address - Phone:949-388-8993
Practice Address - Fax:855-811-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-29
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119497208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty