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General NPI Number Information
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NPI Number | 1134034143
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Entity Type | Organization
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Legal Business Name | KITCHEN BONGOU LLC
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 11400 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-1550
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Country | US
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Telephone | 323-613-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 147 S POINSETTIA PL
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City | LOS ANGELES
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State | CA
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Zip | 90036-2803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES JOSEPH
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Credential |
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Telephone | 323-613-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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