Healthcare Provider Details

I. General information

NPI: 1043130404
Provider Name (Legal Business Name): MBIOTA LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 WILSHIRE BLVD STE 2A
SANTA MONICA CA
90401-1513
US

IV. Provider business mailing address

631 WILSHIRE BLVD STE 2A
SANTA MONICA CA
90401-1513
US

V. Phone/Fax

Practice location:
  • Phone: 800-720-7034
  • Fax:
Mailing address:
  • Phone: 800-720-7034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA SACCO LAMBERTI
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 800-720-7034