Provider Demographics
NPI:1558591065
Name:MIRHAROONI, DESIREE (MPH)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:
Last Name:MIRHAROONI
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 N CANON DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5302
Mailing Address - Country:US
Mailing Address - Phone:310-903-1601
Mailing Address - Fax:
Practice Address - Street 1:238 N CANON DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5302
Practice Address - Country:US
Practice Address - Phone:310-903-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist