Provider Demographics
NPI:1427841014
Name:MEDY WEIGHT LOSS
Entity type:Organization
Organization Name:MEDY WEIGHT LOSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC, NP-C
Authorized Official - Phone:209-403-0951
Mailing Address - Street 1:15810 S. HARLAND ROAD STE B
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:84220-0105
Mailing Address - Country:US
Mailing Address - Phone:209-403-0951
Mailing Address - Fax:
Practice Address - Street 1:15810 S. HARLAND ROAD STE B
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:84220-0105
Practice Address - Country:US
Practice Address - Phone:209-299-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Single Specialty