Provider Demographics
NPI:1053597807
Name:CHRISTI SALEM CORP.
Entity type:Organization
Organization Name:CHRISTI SALEM CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIANNE
Authorized Official - Middle Name:HAMILTON
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:818-399-3903
Mailing Address - Street 1:5129 NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3512
Mailing Address - Country:US
Mailing Address - Phone:818-399-3903
Mailing Address - Fax:
Practice Address - Street 1:21243 VENTURA BLVD STE 137
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2124
Practice Address - Country:US
Practice Address - Phone:818-399-3903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA960887133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty