Provider Demographics
NPI:1225336795
Name:FUN FITNESS INC.
Entity Type:Organization
Organization Name:FUN FITNESS INC.
Other - Org Name:GOLDEN STEPS PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:760-602-7986
Mailing Address - Street 1:4065 OCEANSIDE BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5824
Mailing Address - Country:US
Mailing Address - Phone:760-602-7986
Mailing Address - Fax:760-602-8430
Practice Address - Street 1:4065 OCEANSIDE BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-5824
Practice Address - Country:US
Practice Address - Phone:760-602-7986
Practice Address - Fax:760-602-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3853261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty