Provider Demographics
NPI:1154044584
Name:GYMPERFORMANCE EXERCISE MACHINE LLC
Entity type:Organization
Organization Name:GYMPERFORMANCE EXERCISE MACHINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-725-6724
Mailing Address - Street 1:3542 FRUITVALE AVE # 416
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2327
Mailing Address - Country:US
Mailing Address - Phone:909-725-6724
Mailing Address - Fax:
Practice Address - Street 1:3400 STEVENSON BLVD APT M14
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-5829
Practice Address - Country:US
Practice Address - Phone:909-725-6724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty