Functional Athletics LLC

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

Legal business name

FUNCTIONAL ATHLETICS LLC

Practice address

409 Camino del Rio S Ste 203
San Diego, CA 92108-3506

Phone

(619) 294-3259

NPI assigned

Aug 16, 2023

Organization subpart

No

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

Authorized official

Name

Tim George

Title

Owner/Clinic Director

Phone

(619) 294-3259

Specialties & licenses 1

Addresses

Other names 1

• Egoscue of San Diego Doing business as

Locations

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1376326017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083506",
            "telephone_number": "619-294-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083506",
            "telephone_number": "619-294-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL ATHLETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER/CLINIC DIRECTOR",
        "authorized_official_telephone_number": "619-294-3259"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Egoscue of San Diego",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fun Lac
• Function Fit Rehab
• Function Fit Rehabilitation
• Function Foundation, Inc.
• Function in Movement Physical Therapy
• Functional Physical Therapy Solutions Inc
• Functionsmart
• Fundamental Health
• Paige Noelle Funderburk, OTD, CLT, NDT
• Brent W Fundingsland, M.D.

• Clinical Exercise Physiologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Exercise Physiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.