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Contact Information

METABOLIC MEDICINE & FITNESS CENTER
17542 17TH ST
SUITE 410
TUSTIN, CA92780-1959
 Phone: 714-541-4343
 Fax: 714-835-9550
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for METABOLIC MEDICINE & FITNESS CENTER

NPI Number 1356738769
LBN Legal business name METABOLIC MEDICINE & FITNESS CENTER
Authorized official ERIC PHAM - (MEDICA DOCTOR/ OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/23/2015
Last updated 06/20/2018 - About 8 years ago
Identifiers
CA License # A78428B
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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