Healthcare Provider Details

I. General information

NPI: 1912722398
Provider Name (Legal Business Name): WORLD FOOD BANK, KITCHEN, AND URBAN FARM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S VAN NESS AVE APT 3
LOS ANGELES CA
90020-4697
US

IV. Provider business mailing address

410 S VAN NESS AVE APT 2
LOS ANGELES CA
90020-4697
US

V. Phone/Fax

Practice location:
  • Phone: 310-487-5679
  • Fax:
Mailing address:
  • Phone: 323-476-5126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEEN ZADI
Title or Position: PRESIDENT
Credential:
Phone: 323-476-5126