Provider Demographics
NPI:1952449860
Name:THE CENTER FOR MEDICAL NUTRITION & EXERCISE SCIENCE
Entity Type:Organization
Organization Name:THE CENTER FOR MEDICAL NUTRITION & EXERCISE SCIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-471-1800
Mailing Address - Street 1:230 S 68TH ST
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8176
Mailing Address - Country:US
Mailing Address - Phone:515-471-1832
Mailing Address - Fax:515-267-1379
Practice Address - Street 1:230 S 68TH ST
Practice Address - Street 2:SUITE 1102
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8176
Practice Address - Country:US
Practice Address - Phone:515-471-1832
Practice Address - Fax:515-267-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00948133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty