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General NPI Number Information
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NPI Number | 1407147473
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Entity Type | Organization
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Legal Business Name | APPLE A DAY NUTRITION SERVICES
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Dates
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Enumeration Date | 04/26/2011
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 5720 LEMON AVE UNIT # H
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City | LONG BEACH
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State | CA
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Zip | 90805-4771
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Country | US
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Telephone | 310-462-1012
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Fax | 323-952-4303
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Provider Business Mailing Address
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Address Line | 5720 LEMON AVENUE UNIT # H
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City | LONG BEACH
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State | CA
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Zip | 90805-4772
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Country | US
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Telephone | 310-462-1012
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Fax | 323-952-4303
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. ANTOINETTE DALENE MILLER
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Credential | CNS, MS
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Telephone | 310-462-1012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 133N00000X
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License Number State | CA
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