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General NPI Number Information
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NPI Number | 1932548252
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Entity Type | Organization
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Legal Business Name | HEALTH NUTS
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 9475 LA SALLE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90047-3836
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Country | US
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Telephone | 323-219-6188
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Fax | 323-777-2160
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Provider Business Mailing Address
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Address Line | 9475 LA SALLE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90047-3836
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Country | US
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Telephone | 323-219-6188
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Fax | 323-777-2160
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Authorized Official
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Title or Position | LICENSE VOCATIONAL NURSE
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Name | MS. RHONDA RENEE JORDAN
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Credential | LVN
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Telephone | 323-219-6188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 269742
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License Number State | CA
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