Healthcare Provider Details

I. General information

NPI: 1801155262
Provider Name (Legal Business Name): NEXSTEP FITNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4447 REDONDO BEACH BLVD
LAWNDALE CA
90260-3465
US

IV. Provider business mailing address

4447 REDONDO BEACH BLVD
LAWNDALE CA
90260-3465
US

V. Phone/Fax

Practice location:
  • Phone: 310-546-5666
  • Fax: 310-542-8868
Mailing address:
  • Phone: 310-546-5666
  • Fax: 310-542-8868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JANNE KOURI
Title or Position: PRESIDENT/FOUNDER
Credential:
Phone: 310-546-5666