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General NPI Number Information
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NPI Number | 1518404201
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Entity Type | Organization
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Legal Business Name | THE GUT CAUSE LLC
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 5666 WHITEWATER ST
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City | YORBA LINDA
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State | CA
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Zip | 92887-3736
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Country | US
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Telephone | 714-989-6246
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Fax |
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Provider Business Mailing Address
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Address Line | 5666 WHITEWATER ST
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City | YORBA LINDA
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State | CA
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Zip | 92887-3736
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Country | US
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Telephone | 714-989-6246
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Fax |
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Authorized Official
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Title or Position | FOUNDER/DIRECTOR
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Name | MR. ROBERT JAMES NESBITT JR.
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Credential | CTNC, FDN-P
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Telephone | 714-989-6246
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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 | ITN-01082016
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License Number State | CA
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