Healthcare Provider Details

I. General information

NPI: 1104690189
Provider Name (Legal Business Name): HLT NUTRITION CO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 US HIGHWAY 86 STE 1
BRAWLEY CA
92227-9648
US

IV. Provider business mailing address

PO BOX 64
BRAWLEY CA
92227-0064
US

V. Phone/Fax

Practice location:
  • Phone: 760-996-4717
  • Fax:
Mailing address:
  • Phone: 760-996-4717
  • Fax: 888-549-9864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: ANNABEL MARIE HUBER
Title or Position: PRESIDENT
Credential: RD
Phone: 760-996-4717