Healthcare Provider Details
I. General information
NPI: 1750169389
Provider Name (Legal Business Name): FITNESS COVERED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5815 W SUNSET BLVD STE 105
LOS ANGELES CA
90028-6481
US
IV. Provider business mailing address
5815 W SUNSET BLVD STE 105
LOS ANGELES CA
90028-6481
US
V. Phone/Fax
- Phone: 310-999-3521
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEV
REYS
Title or Position: EMPLOYEE
Credential:
Phone: 310-738-1464