Provider Demographics
NPI:1235504564
Name:PSYCHFITNESS, APMC
Entity type:Organization
Organization Name:PSYCHFITNESS, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-867-6031
Mailing Address - Street 1:409 N PACIFIC COAST HWY
Mailing Address - Street 2:SUITE 441
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2870
Mailing Address - Country:US
Mailing Address - Phone:714-867-6031
Mailing Address - Fax:714-867-6033
Practice Address - Street 1:12373 LEWIS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4676
Practice Address - Country:US
Practice Address - Phone:714-867-6031
Practice Address - Fax:714-867-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty