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General NPI Number Information
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NPI Number | 1184593303
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Entity Type | Organization
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Legal Business Name | MY DIABETES TUTOR INC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 515 W GRANGEVILLE BLVD
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City | HANFORD
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State | CA
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Zip | 93230-2861
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Country | US
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Telephone | 844-623-0999
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Fax | 844-306-5999
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Provider Business Mailing Address
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Address Line | 515 W GRANGEVILLE BLVD
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City | HANFORD
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State | CA
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Zip | 93230-2861
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Country | US
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Telephone | 844-623-0999
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Fax | 844-306-5999
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Authorized Official
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Title or Position | FOUNDER/ CMO
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Name | PREM SAHASRANAM
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Credential | MD
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Telephone | 559-587-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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