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General NPI Number Information
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NPI Number | 1407629132
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Entity Type | Organization
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Legal Business Name | KHANUTRITION, LLC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 9414 ROSE GARDEN PL
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City | RIVERSIDE
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State | CA
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Zip | 92508-8012
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Country | US
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Telephone | 818-913-1883
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Fax |
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Provider Business Mailing Address
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Address Line | 9414 ROSE GARDEN PL
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City | RIVERSIDE
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State | CA
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Zip | 92508-8012
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Country | US
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Telephone | 818-913-1883
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | ASMA KHAN
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Credential | MPH, RD
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Telephone | 818-913-1883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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