Provider Demographics
NPI:1811265846
Name:MARGOLIN, CATHY (LAC, DIPLOM)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:
Last Name:MARGOLIN
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 S ROBERTSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1403
Mailing Address - Country:US
Mailing Address - Phone:877-818-9990
Mailing Address - Fax:
Practice Address - Street 1:1171 S ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1403
Practice Address - Country:US
Practice Address - Phone:877-818-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA12568132700000X, 172M00000X, 174H00000X
CA12568133N00000X, 133NN1002X, 173C00000X, 174H00000X
CAAC 12568171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172M00000XOther Service ProvidersMechanotherapist
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator