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General NPI Number Information
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NPI Number | 1831605625
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Entity Type | Organization
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Legal Business Name | MED FIT CONSULTING, INC.
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Dates
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Enumeration Date | 12/16/2017
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Last Update Date | 12/16/2017
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Provider Practice Location Address
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Address Line | 10425 TIERRASANTA BLVD STE 108
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City | SAN DIEGO
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State | CA
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Zip | 92124-2618
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Country | US
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Telephone | 858-382-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 11384 COPPERLEAF LN
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City | SAN DIEGO
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State | CA
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Zip | 92124-2803
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Country | US
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Telephone | 858-382-6200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERALD COOK
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Credential | MD
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Telephone | 858-382-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | A110724
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License Number State | CA
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