Provider Demographics
NPI:1851848659
Name:ACADEMY OF NUTRITION AND DIETETICS
Entity Type:Organization
Organization Name:ACADEMY OF NUTRITION AND DIETETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:COMFORT
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:OGBUNAMIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RDN,FAND
Authorized Official - Phone:323-299-8521
Mailing Address - Street 1:4537 DON TONITO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4114
Mailing Address - Country:US
Mailing Address - Phone:323-299-8521
Mailing Address - Fax:323-299-8521
Practice Address - Street 1:4537 DON TONITO DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-4114
Practice Address - Country:US
Practice Address - Phone:323-299-8521
Practice Address - Fax:323-299-8521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty