Healthcare Provider Details

I. General information

NPI: 1851087514
Provider Name (Legal Business Name): GIORDANO CASTRANOVA MS RD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 W BURBANK BLVD STE 101
BURBANK CA
91505-2114
US

IV. Provider business mailing address

4205 W BURBANK BLVD STE 101
BURBANK CA
91505
US

V. Phone/Fax

Practice location:
  • Phone: 818-605-1026
  • Fax: 334-746-5457
Mailing address:
  • Phone: 818-605-1026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number86060994
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number86060994
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number86060994
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number86060994
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number86060994
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number86060994
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86060994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: