MEDICARE: LULIS CATERING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174200000X	Meals Provider

General Provider Information

NPI Number	:	1962347864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LULIS CATERING, INC.

Provider Business Mailing Address
First Line	:	7640 BURNET AVE # A
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91405-1005
Country	:	US
Telephone Number	:	818-442-2310
Fax Number	:	818-442-2310

Provider Business Practice Location Address
First Line	:	15136 STAGG ST # 3
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91405-1025
Country	:	US
Telephone Number	:	818-442-2310
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOSHE MIKE MOYAL
Credential	:
Telephone Number	:	818-442-2310

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “LULIS CATERING, INC. ” Practice Location

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