Provider Demographics
NPI:1578203741
Name:MED FIT MANAGEMENT GROUP LLC
Entity Type:Organization
Organization Name:MED FIT MANAGEMENT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEING EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-263-5241
Mailing Address - Street 1:3270 GREYLING DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2230
Mailing Address - Country:US
Mailing Address - Phone:530-263-5241
Mailing Address - Fax:
Practice Address - Street 1:3270 GREYLING DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2230
Practice Address - Country:US
Practice Address - Phone:530-263-5241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty