Healthcare Provider Details

I. General information

NPI: 1225337843
Provider Name (Legal Business Name): NUTRITION PLUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11207 S LA CIENEGA BLVD
LOS ANGELES CA
90045-6112
US

IV. Provider business mailing address

11207 S LA CIENEGA BLVD
LOS ANGELES CA
90045-6112
US

V. Phone/Fax

Practice location:
  • Phone: 310-670-6337
  • Fax: 877-513-0770
Mailing address:
  • Phone: 310-670-6337
  • Fax: 877-513-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY50593
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AFROOZ JAVANFARD
Title or Position: OWNER
Credential:
Phone: 310-273-1939