Organization
FIT ATHLETIC CLUB SAN DIEGO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD SHAW (GENERAL MANAGER)
(858) 675-4480
Entity
Organization
Contact information
Practice address
350 10TH AVE, SAN DIEGO, CA 92101-7496
(619) 764-5348
Mailing address
350 10TH AVE, SAN DIEGO, CA 92101-7496
(619) 764-5348
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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