Metabolic Medicine & Fitness Center

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

A78428B Issued in CA

Legal business name

METABOLIC MEDICINE & FITNESS CENTER

Practice address

17542 17TH St
Suite 410
Tustin, CA 92780-1959

Phone

(714) 541-4343

Fax

(714) 835-9550

NPI assigned

Apr 23, 2015

Last updated

Jun 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric H. Pham, M.D.NPI 1124055041

Title

Medica Doctor/ Owner

Phone

(714) 541-4343

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric H Pham, MD

  • Surgery Physician
  • Orange, CA
  • NPI 1124055041
  Authorized official Same address or phone

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1356738769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17542 17TH ST",
            "address_2": "SUITE 410",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801959",
            "telephone_number": "714-541-4343",
            "fax_number": "714-835-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17542 17TH ST",
            "address_2": "SUITE 410",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801959",
            "telephone_number": "714-541-4343",
            "fax_number": "714-835-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METABOLIC MEDICINE & FITNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MEDICA DOCTOR/ OWNER",
        "authorized_official_telephone_number": "714-541-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "A78428B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moothedath A Menon, M.D.
• Mental Wellness Acupuncture
• Allison Merrick, PH.D.
• Mervin Low, MD, a Professional Corporation
• Mesa Pharmacy
• Beatriz Ademar Meza Payan, ACSW
• Michael J Chen, D.D.S. Inc. (Tustin Dental Group)
• Michael J. Paquette, D.D.S., Inc.
• Michael K Corey Chiropractic Inc (WellnessStop Chiropractic Health Center)
• Michael Oefelein, MD

• Preferred Provider Organization in Tustin, CA
• Providers in Tustin, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.