Provider Demographics
NPI:1720650229
Name:THE GENTLE NUTRITION RD PC
Entity Type:Organization
Organization Name:THE GENTLE NUTRITION RD PC
Other - Org Name:THE GENTLE NUTRITION RD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:310-817-6774
Mailing Address - Street 1:2828 ROWENA AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-4307
Mailing Address - Country:US
Mailing Address - Phone:224-388-5959
Mailing Address - Fax:
Practice Address - Street 1:1545 N LAUREL AVE APT 214
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-2582
Practice Address - Country:US
Practice Address - Phone:310-817-6774
Practice Address - Fax:213-260-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty