Provider Demographics
NPI:1437810710
Name:LAUREN CORNELL NUTRITION, INC.
Entity Type:Organization
Organization Name:LAUREN CORNELL NUTRITION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:424-259-3652
Mailing Address - Street 1:1507 7TH ST # 175
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2605
Mailing Address - Country:US
Mailing Address - Phone:424-259-3652
Mailing Address - Fax:424-258-9404
Practice Address - Street 1:2001 S BARRINGTON AVE STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5337
Practice Address - Country:US
Practice Address - Phone:424-259-3652
Practice Address - Fax:424-258-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty