Healthcare Provider Details
I. General information
NPI: 1245832286
Provider Name (Legal Business Name): MARRIED TO HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/13/2020
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4533 MACARTHUR BLVD
NEWPORT BEACH CA
92660-2059
US
IV. Provider business mailing address
4533 MACARTHUR BLVD
NEWPORT BEACH CA
92660-2059
US
V. Phone/Fax
- Phone: 949-373-5559
- Fax:
- Phone: 949-373-5559
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
MARIN
Title or Position: COO
Credential: RD
Phone: 626-315-3756