Fit Athletic Club San Diego LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FIT ATHLETIC CLUB SAN DIEGO LLC

Practice address

350 10TH Ave
San Diego, CA 92101-7496

Phone

(619) 764-5348

NPI assigned

Apr 12, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chad Shaw

Title

General Manager

Phone

(858) 675-4480

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jackson Reiss

  • Physical Therapist
  • San Diego, CA
  • NPI 1376307496
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1073047593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 10TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017496",
            "telephone_number": "619-764-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 10TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017496",
            "telephone_number": "619-764-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIT ATHLETIC CLUB SAN DIEGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "858-675-4480"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Fishman
• Fisiopro1
• Matthew Fisk
• Katelan Van Saun Fiske, M.S. CCC-SLP
• Mariah Jordan Fiske
• Fit Athletic CMR LLC
• Fit Athletic Physical Therapy, Inc.
• Fit Athletic Physical Therapy, Inc.
• Fit Athletic Physical Therapy, Inc.
• Fit Athletic Physical Therapy, Inc.

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.